Summary & Overview
CPT 80194: Quinidine Quantitative Assay
CPT code 80194 denotes a laboratory test that quantitatively measures quinidine levels in patient specimens. This assay supports clinical management of certain cardiac arrhythmias by informing therapeutic dosing and monitoring for toxicity. As a specialized chemistry/pharmacology test, it is relevant across hospital and reference laboratory settings nationwide and factors into pharmacy, cardiology, and laboratory workflows.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national-level view of clinical context, typical sites of service, common billing modifiers and administrative considerations, and related laboratory service benchmarks. It highlights how payers commonly categorize and reimburse specialized pharmacology assays and outlines operational considerations for laboratory reporting.
Readers will find: a concise clinical description of the assay and its role in arrhythmia management; the typical laboratory setting and service type; a summary of payer coverage landscape and common billing modifiers used with this service; and notes on documentation and coding contexts relevant to laboratory and cardiology practices. Data not available in the input is identified where applicable.
Billing Code Overview
CPT code 80194 describes a quantitative laboratory analysis for quinidine. The service involves a laboratory analyst performing the technical procedures necessary to measure the amount of quinidine present in a patient specimen. Clinicians use quinidine levels to guide treatment of certain cardiac arrhythmias (irregular heartbeats).
Service type: Clinical laboratory toxicology/pharmacology assay (quantitative drug level testing)
Typical site of service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with a history of atrial fibrillation is maintained on quinidine for rate and rhythm control and presents for routine therapeutic drug monitoring. The clinician orders a serum quinidine concentration to ensure levels are therapeutic and to avoid toxicity given symptoms of dizziness and palpitations. The patient attends an outpatient laboratory draw at a hospital outpatient phlebotomy center. The specimen is transported to the clinical chemistry laboratory, where a lab analyst performs the quantitative assay for quinidine using chromatography or immunoassay methods. Results are reported to the ordering cardiologist and the primary care physician to guide dose adjustment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no specific modifier applies |
11 | Regular, minor services | When service is the usual, non-exceptional lab testing visit |
22 |