2025 CPT code 85530
Heparin-protamine tolerance test.
Modifiers may be applicable. Modifier 90 is used if the test is performed by a reference (outside) laboratory. Modifier 91 is used for repeat tests on the same day.
The lab analyst performs the technical lab steps to evaluate heparin activity in patient blood by means of a heparin-protamine tolerance test.
In simple words: This is a lab test that checks how your blood reacts to heparin, a blood thinner. It helps doctors see how well the heparin is working in your body.
This test evaluates heparin activity in patient blood. The test may involve mixing heparinized patient blood with protamine sulfate, a heparin antagonist, and observing the reaction. Although not limited to testing for a specific condition, clinicians may order this test to assess a patient on heparin therapy. Other tests are now more commonly used to monitor heparin therapy, such as partial thromboplastin time (PTT).
Example 1: A patient is started on heparin therapy, and the physician orders a heparin-protamine tolerance test to assess the initial response to the medication., A patient experiencing unexplained bleeding while on heparin therapy undergoes a heparin-protamine tolerance test to evaluate potential heparin overdose or sensitivity., Prior to a surgical procedure, a patient on heparin therapy has a heparin-protamine tolerance test to ensure appropriate heparin levels for minimizing bleeding risk during the surgery.
Documentation should include the reason for the test, the patient's current heparin therapy regimen (if any), and relevant clinical findings.
** This test is considered nearly obsolete, and other tests like PTT are more frequently used for monitoring heparin therapy. Some payers may separately reimburse for specimen collection (e.g., venipuncture using code 36415).
- Revenue Code: T1H - LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE)
- Specialties:Hematology, Clinical Pathology
- Place of Service:Independent Laboratory, Hospital Laboratory