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    v1.0.28
    OpenPayerBilling CodesTherapeutic Drug AssaysCPT cpt-80357-ketamine-norketamine-toxicology-assay
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    CPT 80357: Ketamine and Norketamine Detection in Specimen

    CPT code 80357 describes laboratory testing to measure the amount of or detect the presence of ketamine and norketamine in a patient specimen, a toxicology drug test typically performed by a clinical laboratory using analytic methods such as chromatography/mass spectrometry; service type: quantitative and/or qualitative drug assay; typical site of service: clinical laboratory or hospital laboratory.

    For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only), Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only).

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    Clinical & Coding Specifications

    Clinical Context

    A patient presents to an outpatient clinical laboratory or hospital inpatient unit following administration of ketamine for anesthesia, procedural sedation, pain management, or in the context of suspected illicit drug exposure. Typical scenarios include: a perioperative patient receiving ketamine as an induction or adjunct agent where plasma or urine levels are required for therapeutic drug monitoring or medicolegal documentation; an emergency department patient with altered mental status where toxicology confirms ketamine and its primary metabolite norketamine; or a chronic pain clinic patient undergoing monitoring during off-label ketamine infusion therapy.

    The clinical workflow: the ordering clinician (anesthesiologist, emergency physician, pain specialist, or intensivist) places an order for ketamine/norketamine quantitative or qualitative testing. Phlebotomy or urine collection is performed and the specimen is sent to the clinical laboratory. The laboratory analyst performs the assay, commonly using mass spectrometry or immunoassay methods, to detect and/or quantify ketamine and norketamine. Results are reported to the ordering provider and documented in the medical record to inform clinical management, confirm exposure, evaluate metabolism or clearance, or support forensic/toxicology purposes. Typical sites of service include outpatient laboratories, hospital clinical laboratories, emergency departments, inpatient wards, and specialty infusion centers.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    80357Drug confirmation, ketamine and norketamine, quantitative or qualitative, performed by the laboratory analystPrimary procedure code described — used when the laboratory measures or detects ketamine and norketamine in the specimen
    80306Drug test, definitive, any number of drug classes; quantitative, performed by mass spectrometry, each specimenMay be used for broader definitive toxicology panels that include ketamine when mass spectrometry is performed
    80100Drug assay, qualitative, multiple drug classesUsed when initial qualitative screening for multiple drugs of abuse is performed prior to confirmatory testing for ketamine
    80320Drug confirmation, ethyl alcohol, methanol, isopropanol, other alcohols, quantitativeRelevant when alcohol testing is performed concurrently in impaired patients to evaluate mixed intoxications
    82570Drug assay, ketone bodies, quantitativeOccasionally ordered concurrently in suspected overdose or altered mental status to assess metabolic status alongside ketamine testing

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    90Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    207P00000XEmergency Medicine PhysicianAn emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospit…
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    2085D0003XDiagnostic Neuroimaging (Radiology) PhysicianA licensed physician, who has completed a residency program in Neurology, and who has additional training, experience, and competence in the standards…
    163WX0106XOccupational Health Registered NurseNursing Service Providers · Registered Nurse
    163WA0400XAddiction (Substance Use Disorder) Registered NurseNursing Service Providers · Registered Nurse

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 2

    10 rows

    PolicyPayerEffective Date
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only)UnitedHealthcare2026-08-01
    Antibody-Drug ConjugatesPremera Bluecross2026-08-01
    Chimeric Antigen Receptor (CAR) T-Cell TherapyColorado Rocky Mountain Health Plans2026-08-01
    Allogeneic Hematopoietic Progenitor Cell TherapyAmbetter Georgia2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Idaho Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for New Jersey Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Ohio Only)UnitedHealthcare2026-08-01
    Reblozyl (luspatercept-aamt) Medical Benefit Drug PolicyUnitedHealthcare2026-08-01

    Related Codes

    CPT-80143-ACETAMINOPHEN-QUANTITATIVE-SERUM-ASSAY

    CPT 80143: Acetaminophen Quantitative Assay

    CPT-80145-ADALIMUMAB-LEVEL-ASSAY-THERAPEUTIC-DRUG-MONITORING

    CPT 80145: Adalimumab Quantitative Drug Level Assay

    CPT-80150-AMIKACIN-QUANTITATIVE-ASSAY-THERAPEUTIC-DRUG-MONITORING

    CPT 80150: Amikacin Quantitative Serum Level

    CPT-80151-AMIODARONE-QUANTITATIVE-SERUM-ASSAY

    CPT 80151: Amiodarone Quantitative Drug Level Assay

    CPT-80155-CAFFEINE-LEVEL-TESTING

    CPT 80155: Caffeine Level Quantification

    CPT-80156-CARBAMAZEPINE-TOTAL-LEVEL-LAB-ASSAY

    CPT 80156: Carbamazepine Total Level (Serum)

    CPT-80157-FREE-CARBAMAZEPINE-ASSAY

    CPT 80157: Free Carbamazepine Quantitative Assay

    CPT-80158-CYCLOSPORINE-QUANTITATIVE-ASSAY-LAB

    CPT 80158: Cyclosporine Quantitation, Laboratory

    CPT-80159-CLOZAPINE-LEVEL-ASSAY-THERAPEUTIC-DRUG-MONITORING

    CPT 80159: Clozapine Level Measurement

    CPT-80161-CARBAMAZEPINE-EPOXIDE-QUANTITATIVE-ASSAY

    CPT 80161: Carbamazepine 10,11-Epoxide Level, Quantitative

    Showing 1–10 of 87

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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