2025 CPT code 85366
(Active) Effective Date: N/A Revision Date: N/A Pathology and Laboratory Procedures - Fibrin Degradation Product Testing Hematology and Coagulation Procedures Feed
Paracoagulation test for fibrin degradation products (FDP) in patient plasma.
Modifiers may apply depending on the circumstances, for instance, modifier -90 for tests performed in an outside laboratory.
Medical necessity is established based on clinical indicators suggesting disseminated intravascular coagulation (DIC), monitoring of thrombotic disorders, or assessment of fibrinolytic activity in high-risk patients.Supporting documentation is required to justify the test.
Laboratory personnel perform the test and interpret the results. Clinicians order the test based on patient symptoms and clinical assessment.
In simple words: This lab test checks a blood sample to see if there are fibrin degradation products (FDPs). FDPs are pieces of blood clots that are broken down.The test helps doctors understand if there's too much clotting happening in the blood.
This CPT code encompasses a paracoagulation laboratory procedure to detect fibrin degradation products (FDPs) or fibrin split products (FSPs) in a patient's plasma sample. The test involves mixing the plasma with a reagent that reacts with FDPs, forming clot-like strands if present. A positive result suggests intravascular coagulation, whereas a negative result suggests its absence. Although not limited to any specific condition, it may aid in diagnosing disseminated intravascular coagulation (DIC).However, code 85362 (agglutination method) is often preferred for DIC diagnosis.
Example 1: A patient presents with symptoms suggestive of disseminated intravascular coagulation (DIC). The physician orders 85366 to assess the presence of FDPs in the patient's blood to support the diagnosis., A patient is undergoing monitoring for a condition associated with abnormal clotting.Regular FDP testing using 85366 helps track the patient's clotting status over time., A patient is recovering from a major surgery and is at increased risk for thrombotic complications.The surgeon requests 85366 to check for excessive fibrinolysis.
* Patient demographics and identifiers.* Physician's order specifying the test.* Date and time of sample collection.* Complete blood count (CBC) results.* Relevant clinical information supporting medical necessity.* Laboratory report including the test results and interpretation.
** Always ensure the appropriate laboratory method is selected for accurate coding and reimbursement. Verify payer-specific coverage policies and coding requirements.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: The relative value units (RVUs) for this code will vary based on geographic location, payer, and facility type.Consult the relevant fee schedule for the specific RVU values.
- Global Days : Not applicable; this is a laboratory test.
- Payment Status: Active
- Modifier TC rule: Not applicable; this is a professional component laboratory test.
- Fee Schedule : Historical fee schedule data is not readily available. Consult your payer's fee schedules for historical reimbursement information.
- Specialties:Hematology, Pathology, Critical Care Medicine, Oncology
- Place of Service:Hospital Laboratory, Physician's Office Laboratory, Independent Reference Laboratory