Summary & Overview
CPT 80190: Procainamide Quantitative Drug Monitoring
CPT code 80190 represents a laboratory analytic procedure to quantitate procainamide, an antiarrhythmic medication. Measuring procainamide levels is clinically relevant for therapeutic drug monitoring, dose optimization, and toxicity prevention in patients receiving treatment for cardiac arrhythmias. Nationally, drug level assays like this support medication safety and guide cardiology and clinical pharmacology management.
Key payers commonly involved in coverage and payment for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical purpose of the test, typical sites where the service is performed, and which payers are commonly relevant for coverage considerations. The publication provides benchmarks where available, summarizes common billing practice context, and highlights clinical context for use of the assay. Data not available in the input is noted where relevant.
Billing Code Overview
CPT code 80190 describes a laboratory test in which a lab analyst measures the concentration of procainamide in a patient specimen. Procainamide is an antiarrhythmic medication used to treat arrhythmias (irregular heart rhythms). The service involves the technical laboratory analysis required to quantitate the drug level in blood or other clinical specimens.
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Service type: Therapeutic drug monitoring (laboratory quantitative analysis)
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Typical site of service: Clinical laboratory or hospital laboratory testing facility
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a history of ventricular or supraventricular arrhythmia treated with oral or IV procainamide who requires therapeutic drug monitoring to ensure serum drug concentration is in the therapeutic range and to avoid toxicity. A patient presents to an outpatient cardiology clinic or hospital inpatient unit after a medication dose change, signs of toxicity (e.g., dizziness, confusion, hypotension, QRS prolongation), or recurrent arrhythmia. A provider orders a quantitative serum procainamide level. A phlebotomist or nurse collects a blood specimen, which is sent to the hospital clinical laboratory or a reference lab. In the laboratory, a trained lab analyst performs the technical assay to quantitate procainamide using validated methods (for example, immunoassay or chromatographic techniques), documents specimen handling and instrument run, validates analytic quality controls, and reports the numeric concentration to the ordering clinician. Typical sites of service include hospital inpatient laboratories, outpatient clinical laboratories, and reference diagnostic laboratories associated with cardiology clinics or emergency departments. Turnaround time may vary from stat (ED/inpatient) to routine (outpatient) depending on clinical urgency.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Default; no special circumstances reported |