2025 CPT code 80203
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Laboratory - Therapeutic Drug Assays Pathology and Laboratory Procedures Feed
Quantitative determination of zonisamide levels in a patient's serum or plasma.
Modifiers may apply based on specific circumstances; refer to the most updated CPT and payer guidelines for appropriate modifier application.Potential modifiers may include those indicating the site of service, if performed by an outside lab or repeat testing.
Medical necessity for 80203 is established when monitoring zonisamide therapy is clinically indicated to optimize efficacy, reduce adverse effects, or investigate suspected drug-related issues.Documentation must clearly show that the level of zonisamide requires monitoring based on clinical context.
The clinical responsibility lies with the laboratory performing the assay to accurately measure zonisamide levels in the provided sample. The ordering physician is responsible for ordering the test appropriately and interpreting the results in the context of the patient's clinical picture and treatment plan.
In simple words: This lab test measures the amount of zonisamide medication in your blood.This helps doctors ensure you're getting the right dose of the medicine.
This CPT code, 80203, represents a quantitative therapeutic drug assay for zonisamide.The assay measures the concentration of zonisamide, including its metabolites if present, in a patient's serum, plasma, whole blood, or cerebrospinal fluid specimen.The test is primarily used to monitor drug levels and optimize dosage, particularly when zonisamide is employed as an adjunctive therapy for managing seizures.
Example 1: A patient with epilepsy is on zonisamide as adjunctive therapy.Regular monitoring of zonisamide levels (trough levels before next dose) is necessary to optimize efficacy and minimize side effects. 80203 is used to monitor these levels., A patient experiences adverse effects suspected to be related to zonisamide.To determine if the adverse effects are due to high levels of the drug, the physician orders code 80203 to quantify the zonisamide in the patient's blood., A patient's seizure control worsens. The physician suspects inadequate zonisamide levels and orders test 80203 to assess zonisamide concentration in the blood to adjust the dosage accordingly.
* Patient demographics and identifying information.* Physician order specifying the test (80203).* Date and time of sample collection.* Type of specimen collected (serum or plasma).* Relevant clinical information, including patient's medical history, medication list, and reason for ordering the test.* Complete and accurate laboratory reports with results.
** Always refer to the latest CPT manual and payer guidelines for the most up-to-date coding and billing practices.This information is for guidance only and should not be considered a substitute for professional medical billing expertise.
- Revenue Code: T1H - LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE)
- RVU: Not specified in provided data.RVUs vary by payer and location. Consult your local fee schedule.
- Global Days: Not applicable; this is a laboratory test, not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable to this laboratory test.
- Fee Schedule: Not specified in the provided data. Consult your local fee schedule or payer-specific information for historical fee data.
- Specialties:Neurology, Clinical Pharmacology, Epilepsy
- Place of Service:Office, Hospital (Inpatient or Outpatient), Laboratory