2025 CPT code 80299
(Active) Effective Date: N/A Revision Date: N/A Therapeutic Drug Monitoring - Therapeutic Drug Assays Pathology and Laboratory Feed
Quantitation of therapeutic drug, not elsewhere specified.
Modifiers may be applicable depending on the circumstances of the test (e.g., repeat testing, unusual complexity). Consult modifier guidelines for specific scenarios.
Medical necessity must be established for each test. Justification may include ensuring therapeutic drug levels, assessing drug efficacy or toxicity, and monitoring patient response to treatment.It is dependent on the particular drug, patient condition, and clinical scenario.
Laboratory professionals are responsible for performing the assay, interpreting results, and reporting them to the ordering clinician.The ordering clinician is responsible for using the test results to guide patient treatment.
In simple words: This test measures the amount of a specific medication in your blood to ensure it is within the therapeutic range. It helps doctors determine if the dosage is correct and effective.
This code is used for the quantitative measurement of a therapeutic drug not otherwise specified in the CPT code set.It includes the measurement of parent drug and its metabolites when performed.The specimen is typically whole blood, serum, plasma, or cerebrospinal fluid.
Example 1: A patient is on a newly prescribed medication for epilepsy, and the clinician needs to monitor the drug levels to optimize therapy and minimize side effects., A patient with a heart condition is taking digoxin. Therapeutic drug monitoring is necessary to ensure the drug levels are within therapeutic range and not toxic., A patient is prescribed an antibiotic for a serious infection, and the clinician orders therapeutic drug monitoring to assess the drug's effectiveness and adjust the dosage if needed.
Documentation should include the specific drug being measured, the reason for testing (e.g., monitoring therapeutic levels, assessing compliance), the date and time of sample collection, the specimen type, and the relevant clinical information.
** Always verify the latest coding guidelines and payer policies before billing. Contact the payer for specific coverage policies as they may vary.
- Revenue Code: T1H - LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE)
- Payment Status: Active
- Specialties:Pathology, Clinical Pharmacology, various medical specialties depending on the specific drug being tested
- Place of Service:Independent Laboratory, Hospital Outpatient, Office