2025 CPT code 80336
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Definitive Drug Testing Procedures Pathology and Laboratory Procedures > Drug Assay Procedures Feed
This CPT code reports the definitive testing of three to five tricyclic and other cyclical antidepressants in a patient specimen.
Modifiers may apply depending on the circumstances of service. Examples include modifier 90 (reference laboratory) or 59 (distinct procedural service). Consult your payer for specifics.
Medical necessity is established when there is a clinical indication for testing, such as suspected overdose, monitoring adherence to prescribed medications, or assessing potential drug interactions. Documentation must clearly support the clinical need for this specific panel of antidepressants, and the level of complexity (3-5 analytes) selected must reflect the actual number of analytes tested.
The clinical responsibility lies with the laboratory analyst who performs the test, analyzes the results, and reports them to the ordering physician. The physician is responsible for interpreting the results within the context of the patient's clinical presentation and overall medical history.
In simple words: This lab test checks for three to five types of antidepressant medications in a sample from the patient.It measures how much of the medication is present, or if it's simply present at all.The test helps doctors understand if the patient is taking their medication as prescribed or if there might be an overdose.
CPT code 80336 encompasses the definitive testing of three to five tricyclic and other cyclical antidepressants in a patient specimen.The testing can be qualitative (positive/negative), quantitative (measuring the exact amount), or a combination of both.Definitive methods, such as gas or liquid chromatography-mass spectrometry, are employed to identify individual drugs and distinguish between structural isomers.The specimen type may vary (e.g., serum, plasma, urine) and is specified in the test order.This procedure is used to monitor patient adherence to prescribed medication or to assess potential overdose.
Example 1: A patient presents to the emergency room with symptoms of a possible antidepressant overdose. A serum sample is sent to the lab for testing with CPT code 80336 to identify the specific antidepressants and quantify their concentrations., A psychiatrist is monitoring a patient's adherence to a prescribed regimen of three tricyclic antidepressants. A regular urine sample is collected and analyzed using CPT code 80336 to check for the presence and concentration of the medications., A patient is undergoing a forensic drug screen. The lab uses 80336 to perform definitive testing for a panel of three to five tricyclic antidepressants in a blood sample as part of the comprehensive toxicology workup.
* Patient demographics and relevant clinical information (age, weight, medical history, medications).* Detailed description of the specimen collected (type, date, time, collection method).* The specific antidepressants tested for and their associated metabolites (if any).* Lab report showing the results with specific methodology employed (e.g., HPLC, GC-MS).* Physician's order for the test indicating the clinical indication for testing.
** This code is for definitive drug testing and should not be used in conjunction with presumptive tests for the same analytes on the same date of service.Consult the CPT manual for a complete list of included antidepressants within this code.
- Revenue Code: T1H (LAB TESTS - OTHER)
- RVU: The relative value units (RVUs) for this code vary depending on the payer and the specific circumstances.Check with your payer for the exact RVU values.
- Global Days: Not applicable
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not applicable to this code.
- Fee Schedule: Fee schedules vary by payer and location. Check your payer's fee schedule for the most accurate and up-to-date information. Historical fee data may be available through your payer or billing system.
- Specialties:Psychiatry, Toxicology, Clinical Chemistry
- Place of Service:Office, Hospital (Inpatient and Outpatient), Urgent Care Facility, Laboratory