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2025 CPT code 85250

Clotting; factor IX (PTC or Christmas)

Report 85250 for the assay of factor IX. If other coagulation factors are tested concurrently, use the appropriate codes for those factors. For procedures not specifically listed, use the unlisted hematology and coagulation procedure code 85999.

Modifiers may be applicable. For example, modifier 91 is used for repeat testing.

Medical necessity is established when there's clinical suspicion of a bleeding disorder, monitoring of anticoagulant therapy, or evaluation of liver function and coagulation status. A prolonged aPTT result can also justify medical necessity.

The lab analyst performs all technical steps to assess the presence of factor IX in the patient’s serum. This may involve mixing the patient's plasma with a factor IX deficient substrate, evaluating results with a chromogenic assay, or triggering coagulation and measuring clot formation optically.

In simple words: This blood test checks how well a clotting protein called factor IX is working. It helps doctors diagnose bleeding disorders like hemophilia B or see if medications like warfarin are working correctly.

This test measures the activity of factor IX, a protein crucial for blood clotting. It's used to evaluate prolonged aPTT and diagnose conditions like Hemophilia B (factor IX deficiency). The test can also assess the effectiveness of warfarin therapy, detect vitamin K deficiency, and identify liver disease or other coagulopathies.

Example 1: A patient presents with easy bruising and prolonged bleeding after minor injuries. A factor IX assay is ordered to evaluate for potential Hemophilia B., A patient on warfarin therapy needs their clotting factors monitored. A factor IX assay is performed to assess the medication's effectiveness and adjust dosage as needed., A patient with liver disease undergoes a factor IX assay to evaluate their coagulation status and risk of bleeding complications.

Documentation should include the reason for the test, relevant medical history (e.g., bleeding episodes, family history of bleeding disorders), current medications (especially anticoagulants), and any recent trauma or surgeries.

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