Summary & Overview
CPT 80173: Haloperidol Quantitative Assay, Laboratory Analysis
CPT code 80173 represents a laboratory quantitative assay for haloperidol, an antipsychotic medication. This code is used when a lab performs the technical analytical testing to determine the concentration of haloperidol in a patient specimen. Such testing informs therapeutic monitoring, toxicity assessment, and forensic analyses, making it relevant to psychiatric care, inpatient management, and outpatient laboratory services nationwide.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for haloperidol quantitation, common sites of service, and the service type. The publication provides benchmarking and coverage considerations across major national payers, outlines typical use cases for therapeutic drug monitoring and toxicity evaluation, and summarizes documentation and billing considerations relevant to laboratory providers.
The report highlights where CPT code 80173 fits in lab testing workflows and what clinicians and billing staff should expect in terms of clinical context and payer engagement. Data not available in the input is identified where applicable.
Billing Code Overview
CPT code 80173 describes a laboratory assay to quantitate haloperidol, an antipsychotic medication, performed by a laboratory analyst. The service type is a clinical laboratory toxicology/pharmacology test focused on measuring the amount of haloperidol in a patient specimen. The typical site of service is a clinical laboratory or hospital laboratory where specimens are processed and analyzed using specialized instrumentation and methods.
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Clinical & Coding Specifications
Clinical Context
A 34-year-old inpatient with schizophrenia on chronic haloperidol therapy is admitted for altered mental status and suspected toxicity after dose increase. The treating psychiatrist orders a serum haloperidol concentration to assess adherence and possible overdose. A phlebotomist draws a blood specimen; the specimen is labeled and sent to the hospital clinical chemistry/toxicology laboratory. In the lab, a qualified lab analyst performs the technical assay to quantitate haloperidol level using validated methods (for example, liquid chromatography–tandem mass spectrometry). Results are posted to the electronic medical record and routed to the prescribing psychiatrist and the treating team for interpretation and medication management. Typical site of service: hospital outpatient laboratory or inpatient hospital laboratory; clinical service type: clinical pharmacology/toxicology quantitative drug assay.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing is split and the ordering laboratory physician bills the interpretation or consultative portion (rare for quantitative drug assays). |
TC | Technical component |