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2025 CPT code 80373

Definitive identification of tramadol in a patient specimen.

Adhere to CPT coding guidelines, specifically those for drug assay procedures, including guidelines on definitive drug identification methods, specimen types, and reporting of qualitative and/or quantitative results.Refer to the official CPT manual for the most up-to-date information.

Modifiers may be applicable depending on the specific circumstances of the testing. For example, modifier 90 might be used to indicate an outside laboratory performed the test.Consult CPT guidelines and payer-specific instructions for appropriate modifier usage.

Medical necessity for this test is established by clinical suspicion of tramadol use or abuse, monitoring patient compliance with prescribed medication, or as part of a forensic investigation.Documentation needs to support the clinical indication.

The clinical responsibility lies with the laboratory analyst who performs the test, interprets the results, and reports them to the ordering physician. The physician is responsible for ordering the test based on clinical indication and interpreting the results in the context of the patient's overall clinical picture.

IMPORTANT:If testing for other opioids or opiate analogs is performed, refer to codes 80361-80364 depending on the number of analytes tested. For definitive drug procedures not specified in 80320-80373, use unlisted codes 80375, 80376, or 80377.

In simple words: This lab test checks for the presence and/or amount of tramadol, a pain medication, in a sample (like blood or urine). It uses highly accurate methods to identify tramadol specifically.

This CPT code reports the definitive identification of tramadol in a patient specimen using methods such as gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-mass spectrometry (LC-MS).The test may be qualitative (positive/negative), quantitative (measuring the exact amount), or a combination of both.The specimen type can vary (e.g., urine, serum, blood), but is specified in the test requisition.This procedure distinguishes tramadol from structural isomers but not necessarily stereoisomers and excludes immunoassays and enzymatic methods.

Example 1: A patient presents to the emergency room after suspected opioid overdose. A definitive test for tramadol is ordered to determine its presence and concentration to guide treatment., A patient is undergoing routine drug monitoring as part of a pain management program. A definitive test for tramadol is ordered to assess adherence to the prescribed regimen., A forensic toxicology laboratory is analyzing a sample collected during a criminal investigation. A definitive test for tramadol is performed to determine if it was present in the sample.

The documentation should include the patient's demographic information, the date and time of the sample collection, the type of specimen collected, the specific method used for testing, the test results, and the name and credentials of the testing personnel.The ordering physician's notes should justify the medical necessity of the test.

** Ensure accurate reporting of the number of analytes tested. If testing for other drugs or metabolites, additional codes may be necessary.

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