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The CPT® Code 85549 refers to a laboratory test that measures the levels of muramidase, which is a bacteriolytic enzyme integral to the innate immune system. Muramidase plays a crucial role in the body's defense mechanisms and is predominantly found in various bodily fluids, including tears, saliva, mucus, human breast milk, and the cytoplasmic granules of polymorphonuclear neutrophils. This enzyme is significant because its serum levels can increase in response to the degradation of polymorphonuclear neutrophils, which may occur in both benign conditions such as infections and inflammation, as well as in malignant diseases like acute or chronic granulocytic or monocytic leukemias, specifically classified as FAB-M4, chronic myelogenous leukemia (CML), and chronic myelomonocytic leukemia (CMML). Additionally, elevated levels of muramidase in serum and urine can indicate severe renal insufficiency, renal transplant rejection, and urinary tract infections. The test can be performed on various samples, including blood, urine, tears, and cerebrospinal fluid, with the blood sample obtained through a separately reportable venipuncture. The urine sample can be collected via random void or catheterization. The quantitative measurement of muramidase levels in serum, urine, tears, and cerebrospinal fluid is conducted using a technique known as quantitative radial immunodiffusion, which allows for precise quantification of this important enzyme.
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The muramidase test (CPT® Code 85549) is indicated for various clinical scenarios where the measurement of muramidase levels can provide valuable diagnostic information. The following conditions and situations warrant the performance of this laboratory test:
The procedure for measuring muramidase levels involves several key steps that ensure accurate and reliable results. The following outlines the procedural steps for conducting the muramidase test:
After the muramidase test is completed, the results are analyzed and reported. It is important for healthcare providers to interpret the results in conjunction with the patient's clinical history and other diagnostic findings. Elevated muramidase levels may necessitate further investigation or monitoring, particularly in cases of suspected infection, inflammation, or malignancy. Additionally, if the test is performed in the context of renal insufficiency or transplant rejection, appropriate follow-up care and management strategies should be implemented based on the results. Patients may not require specific post-procedure care, but they should be informed about the significance of the test results and any necessary next steps in their diagnostic or treatment plan.
| Short Descr | MURAMIDASE | Medium Descr | MURAMIDASE | Long Descr | Muramidase | 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 |
| 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GA | Waiver of liability statement issued as required by payer policy, individual case | GZ | Item or service expected to be denied as not reasonable and necessary | Q4 | Service for ordering/referring physician qualifies as a service exemption |
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| Pre-1990 | Added | Code added. |
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