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CPT®
85530

CPT® Code 85530

Official Description

Heparin-protamine tolerance test

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 85530 refers to the Heparin-protamine tolerance test, which is a laboratory procedure designed to evaluate the body's response to heparin and protamine. Heparin is a widely used anticoagulant medication that plays a crucial role in preventing and treating blood clots by inhibiting the formation of fibrin, a key component in blood clotting. Protamine, on the other hand, is a medication that acts as a reversal agent for heparin; it binds to heparin molecules, effectively neutralizing their anticoagulant effects. The heparin-protamine tolerance test is particularly important in clinical settings where patients are undergoing heparin therapy, as it helps to determine how well a patient can tolerate the administration of protamine after heparin treatment. This test is essential for ensuring patient safety and effective management of anticoagulation therapy, especially in situations where rapid reversal of heparin is necessary, such as during surgical procedures or in cases of heparin overdose.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The Heparin-protamine tolerance test (CPT® Code 85530) is indicated for the following conditions:

  • Assessment of Heparin Therapy This test is performed to evaluate how well a patient is responding to heparin therapy, particularly in situations where anticoagulation management is critical.
  • Monitoring for Heparin Reversal It is used to determine the effectiveness of protamine in reversing the anticoagulant effects of heparin, especially in emergency situations or surgical settings.

2. Procedure

The Heparin-protamine tolerance test involves several key procedural steps to ensure accurate measurement of the patient's response to heparin and protamine. The following steps outline the procedure:

  • Step 1: Patient Preparation Prior to the test, the patient may need to be informed about the procedure and any necessary preparations, such as fasting or medication adjustments. It is essential to ensure that the patient is in a stable condition and has not received any anticoagulant medications other than heparin prior to the test.
  • Step 2: Administration of Heparin The test begins with the administration of a specific dose of heparin, which is typically given intravenously. The dosage may vary based on the patient's clinical condition and the protocol established by the healthcare provider.
  • Step 3: Administration of Protamine After a designated period, protamine is administered to the patient. This step is crucial as it allows for the assessment of how effectively protamine can reverse the anticoagulant effects of heparin.
  • Step 4: Monitoring and Testing Following the administration of protamine, the patient's response is closely monitored. Blood samples may be taken at specific intervals to measure coagulation parameters and determine the effectiveness of the protamine in reversing heparin's effects.

3. Post-Procedure

After the Heparin-protamine tolerance test, patients are typically monitored for any adverse reactions to the medications administered. It is important to observe for signs of bleeding or clotting complications. The healthcare provider will review the test results to assess the patient's tolerance to protamine and make any necessary adjustments to their anticoagulation therapy. Depending on the results, further testing or modifications to the patient's treatment plan may be required to ensure optimal management of their anticoagulation needs.
Short Descr HEPARIN-PROTAMINE TOLERANCE
Medium Descr HEPARIN-PROTAMINE TOLERANCE TST
Long Descr Heparin-protamine tolerance test
Status Code Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
CLIA Waived (QW) No
APC Status Indicator Conditionally packaged laboratory tests
Type of Service (TOS) 5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS) T1H - Lab tests - other (non-Medicare fee schedule)
MUE 1
CCS Clinical Classification 233 - Laboratory - Chemistry and Hematology
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
91 Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient.
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