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The CPT® Code 85597 refers to a specific laboratory test known as phospholipid neutralization, which is commonly associated with the detection of lupus anticoagulants (LA). This test is also referred to as an anti-phospholipid antibody test. Lupus anticoagulants are a diverse group of antibodies that target phospholipid-protein complexes within the body. The presence of these antibodies in the bloodstream can lead to an extended clotting time, which is a critical factor in assessing coagulation disorders. The test operates on the principle that when lysed platelet phospholipid is introduced into a sample containing lupus anticoagulants, these antibodies are neutralized, resulting in a shortened clotting time. The methodology employed in this test involves photo-optical clot detection, which allows for precise measurement of clotting times. By comparing the clotting time of the sample with and without the addition of lysed platelet phospholipid, healthcare professionals can determine the presence of lupus anticoagulants. An increased clotting time in the absence of lysed platelet phospholipid indicates a positive result for LA. While a positive test result may suggest the presence of systemic lupus erythematosus (SLE), it is important to note that most individuals who test positive for lupus anticoagulants do not have SLE. This test is frequently utilized to investigate the underlying causes of unexplained thrombosis, recurrent fetal loss, thrombocytopenia, or prolonged partial thromboplastin time (PTT) tests, making it a valuable tool in the diagnostic process for various hematological conditions.
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The phospholipid neutralization test (CPT® Code 85597) is indicated for several clinical scenarios where the presence of lupus anticoagulants may be suspected. The following conditions and symptoms warrant the performance of this test:
The procedure for conducting the phospholipid neutralization test involves several key steps that ensure accurate results. The following outlines the procedural steps:
After the phospholipid neutralization test is completed, the laboratory will analyze the results and report them to the requesting physician. There are no specific post-procedure care requirements for patients, as the test is minimally invasive and does not typically result in complications. However, it is essential for healthcare providers to interpret the results in the context of the patient's overall clinical picture, as a positive test for lupus anticoagulants may necessitate further evaluation and management of potential underlying conditions. Follow-up consultations may be required to discuss the implications of the test results and to determine any necessary treatment or additional testing.
| Short Descr | PHOSPHOLIPID PLTLT NEUTRALIZ | Medium Descr | PHOSPHOLIPID NEUTRALIZATION PLATELET | Long Descr | Phospholipid neutralization; platelet | 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. | 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. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 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. | 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 |
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| 2011-01-01 | Changed | Long description revised. Medium description changed. Short description changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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