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BETA v.3.0

2025 CPT code 80230

Infliximab (Remicade) level.

Report 80230 for the quantitative measurement of infliximab. If antibody testing for infliximab (ATI) is also performed, report it separately with the appropriate code.

Modifiers may be applicable. Modifier 91 is used for repeat laboratory tests on the same day. Modifier 90 indicates the test was performed by a reference laboratory.

Medical necessity for infliximab level testing is established when the results will directly impact patient management decisions, such as dosage adjustments or treatment changes. Specifically, testing is justified for monitoring therapeutic efficacy, assessing for subtherapeutic or toxic drug levels, or evaluating loss of response to therapy.

Laboratory professionals are responsible for performing the technical aspects of the infliximab assay, including specimen preparation, analysis via methods like LC-MS/MS, and reporting quantitative results. Clinicians interpret the results to guide patient management.

In simple words: This test measures the amount of Remicade (infliximab) in your blood. It helps your doctor determine if your current dose is appropriate for managing your condition.

This code represents the quantitative measurement of infliximab levels in a patient's serum. Infliximab, sold under the brand name Remicade among others, is a therapeutic antibody medication used to treat autoimmune diseases such as rheumatoid arthritis, Crohn's disease, ulcerative colitis, ankylosing spondylitis, psoriatic arthritis, and plaque psoriasis. The test is typically performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) and assists clinicians in monitoring patient response to infliximab therapy and adjusting dosages as needed.

Example 1: A patient with Crohn's disease experiencing a flare-up undergoes infliximab level testing to determine if the current dosage is adequate for controlling inflammation., A patient with rheumatoid arthritis who has recently started infliximab therapy has their levels monitored to assess treatment response and minimize potential side effects., A patient on long-term infliximab treatment for ankylosing spondylitis undergoes routine testing to ensure therapeutic drug levels are maintained and adjust dosage as necessary.

Documentation should include the reason for testing, the date and time of specimen collection, the specific method used for analysis, the quantitative result, and the ordering clinician's interpretation of the result in the context of the patient's clinical presentation.

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