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The CPT® Code 85613 refers to the Russell viper venom time (RVVT) test, specifically the diluted version of this test. This procedure involves obtaining a blood sample from the patient, which is then analyzed to measure the RVVT. The primary purpose of this test is to detect the presence of lupus anticoagulants in the plasma. Lupus anticoagulants are a type of nonspecific clotting inhibitor that can interfere with the normal clotting process, potentially leading to increased risk of thrombosis. In contrast to the undiluted RVVT test, which is coded under CPT® Code 85612, the diluted RVVT (dRVVT) utilizes a low phospholipid reagent that consists of Russell viper venom combined with excess calcium. This dilution is crucial as it lowers the phospholipid concentration, thereby enhancing the sensitivity of the test for identifying lupus anticoagulants. The measurement of clotting time is performed using a photo-optical method, which provides an accurate assessment of the coagulation status of the patient’s plasma in relation to the presence of these inhibitors.
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The Russell viper venom time (RVVT) test, specifically the diluted version coded as CPT® 85613, is indicated for the evaluation of patients suspected of having lupus anticoagulants. The presence of these anticoagulants can lead to various clinical conditions, including increased risk of thrombosis and complications in patients with autoimmune disorders. The test is particularly useful in the context of unexplained thrombotic events or in patients with a history of recurrent pregnancy loss, where the identification of lupus anticoagulants may guide further management and treatment decisions.
The procedure for conducting the diluted Russell viper venom time (dRVVT) test involves several key steps to ensure accurate measurement of clotting time. First, a blood sample is collected from the patient, typically via venipuncture. This sample is then processed to obtain plasma, which is essential for the test. Next, the diluted RVVT reagent, which consists of Russell viper venom and excess calcium, is prepared. The dilution of the reagent is critical as it reduces the phospholipid concentration, thereby increasing the sensitivity of the test for detecting lupus anticoagulants. The prepared reagent is mixed with the patient’s plasma in a controlled environment. Following this, the clotting time is measured using a photo-optical method, which allows for precise detection of the time it takes for the plasma to clot in response to the diluted venom. This measurement is then analyzed to determine the presence of lupus anticoagulants, providing valuable information for the clinician regarding the patient’s coagulation status.
After the completion of the diluted Russell viper venom time (dRVVT) test, the patient may be monitored for any immediate reactions, although the procedure is generally well-tolerated. The results of the test will be analyzed and interpreted by the healthcare provider, who will consider the findings in conjunction with the patient’s clinical history and other laboratory results. Depending on the outcome, further testing or treatment may be recommended to address any identified coagulation disorders. It is important for the healthcare provider to communicate the results to the patient and discuss any necessary follow-up actions or lifestyle modifications that may be required based on the test findings.
| Short Descr | RUSSELL VIPER VENOM DILUTED | Medium Descr | RUSSELL VIPER VENOM TIME DILUTED | Long Descr | Russell viper venom time (includes venom); diluted | 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 | 3 | CCS Clinical Classification | 233 - Laboratory - Chemistry and Hematology |
| 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. | 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. | 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. | Q4 | Service for ordering/referring physician qualifies as a service exemption | GZ | Item or service expected to be denied as not reasonable and necessary | GA | Waiver of liability statement issued as required by payer policy, individual case | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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. | GW | Service not related to the hospice patient's terminal condition | 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 | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study |
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| 2011-01-01 | Changed | Short description changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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