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2025 CPT code 80357

Ketamine and norketamine analysis.

Code 80357 is specifically for definitive drug testing of ketamine and norketamine. If other drug classes are being tested concurrently, the appropriate codes for those drug classes should also be reported. Presumptive drug screenings are reported with different codes and should not be confused with definitive testing.

Modifiers may be applicable depending on the circumstances of the testing. Modifier 91 is used for repeat tests on the same date of service. Modifier 59 may be used to distinguish testing on different specimens.

Medical necessity is established by the clinical rationale for the test. This may include suspicion of overdose, monitoring of substance use disorder treatment, or forensic requirements.

Laboratory personnel are responsible for performing the analysis and providing accurate results of the ketamine and norketamine concentrations in the patient specimen.

In simple words: This test checks for the presence and/or amount of ketamine and its byproduct, norketamine, in a sample like blood or urine. It's used to confirm ketamine use, rather than just screen for it.

This code represents the definitive analysis of ketamine and its metabolite, norketamine, in a patient specimen. The testing methodology must be able to distinguish between structural isomers, and may be qualitative, quantitative, or both. The result reports the presence or absence and/or the measured amount of both ketamine and norketamine. This test is distinct from presumptive drug class screenings and therapeutic drug assays.

Example 1: A patient presents to the emergency department with signs and symptoms suggestive of a ketamine overdose. A definitive drug test is ordered to confirm the presence and quantify the level of ketamine and norketamine in the patient's system to guide treatment., A patient undergoing treatment for ketamine addiction requires regular monitoring of their abstinence. A definitive drug test using code 80357 is ordered to assess the presence or absence of ketamine and its metabolite, norketamine., A forensic investigation requires precise identification and quantification of ketamine and its metabolite in a biological sample. Code 80357 is used to report the definitive testing conducted.

Documentation should include the reason for testing (e.g., overdose, monitoring, forensic investigation), the specimen type (e.g., urine, blood), and the testing methodology employed. The report should clearly indicate the presence or absence and/or the measured quantity of both ketamine and norketamine.

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