Summary & Overview
CPT 80201: Topiramate Quantitative Assay
CPT code 80201 is a laboratory service for the quantitative measurement of topiramate, an anticonvulsant medication. As a therapeutic drug monitoring and toxicology assay, this code is used when a laboratory analyst performs the technical testing to determine a patient’s topiramate concentration. Nationally, accurate measurement of antiseizure medication levels supports safe dosing, adherence assessment, and clinical management across outpatient and inpatient settings.
Key payers in standard analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise profile of the code’s clinical role, typical sites of service, and common modifiers used in billing. The publication outlines benchmarks and payer coverage trends where available, clarifies coding context for laboratory service lines, and highlights policy or reimbursement updates relevant to quantitative drug assays. The summary also provides practical references for clinical teams and billing staff on how this code fits within therapeutic drug monitoring workflows.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 80201 describes a quantitative laboratory test performed by a laboratory analyst to measure the concentration of topiramate, an anticonvulsant medication, in a patient specimen. This service represents a toxicology/therapeutic drug monitoring procedure focused on determining serum or plasma levels of topiramate.
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Service type: Quantitative laboratory analysis / therapeutic drug monitoring
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Typical site of service: Clinical laboratory or hospital laboratory (specimen collected in outpatient clinics, inpatient settings, or reference lab collection sites)
Clinical & Coding Specifications
Clinical Context
A 28-year-old outpatient with a history of seizure disorder treated with topiramate presents for routine therapeutic drug monitoring after dose adjustment due to breakthrough partial seizures. A urine or serum sample is collected in the ambulatory phlebotomy area and sent to the clinical chemistry/toxicology laboratory. The lab analyst performs a quantitative assay to measure the concentration of topiramate in the specimen to assess adherence, therapeutic level, or potential toxicity. Results are reported to the ordering neurologist and entered into the electronic health record; abnormal or unexpected levels prompt clinician review for dose change or further testing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard claim line when no special modifier applies |
26 | Professional component | When billing only the professional component for interpretation or analytical oversight |
TC |