CPT 82415: Chloramphenicol Drug Level, Serum or Plasma

CPT code 82415 denotes a laboratory assay that quantifies chloramphenicol levels in serum or plasma. Although chloramphenicol is infrequently prescribed because of serious adverse effects, measuring blood concentrations can be clinically important when the drug is used to confirm therapeutic levels or assess toxicity. Nationally, this test is a specialized toxicology/therapeutic drug monitoring service with limited utilization but retained clinical relevance for select cases.

Key payers referenced in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines how these payers typically address coverage for specialized therapeutic drug monitoring and highlights common billing considerations.

Readers will learn the clinical context for ordering a chloramphenicol level, typical sites of service, and what to expect in terms of payer coverage patterns and documentation needs. The report also presents benchmarks and policy considerations relevant to low-volume, high-specialty laboratory codes, and notes where input was not available for certain fields. This summary provides clinicians, laboratory managers, and billing professionals with a concise overview of CPT code 82415 and the operational and policy factors that affect its use nationally.

Billing Code Overview

CPT code 82415 reports a therapeutic drug level assay for chloramphenicol performed on a serum or plasma specimen. The test measures the concentration of the antibiotic chloramphenicol, a broad-spectrum agent with rare contemporary use due to serious potential adverse effects.

Service type: Therapeutic drug monitoring / clinical laboratory assay

Typical site of service: Clinical laboratory or hospital laboratory where serum or plasma specimens are analyzed. Tests may be ordered when monitoring is clinically necessary despite the drug's limited use.

Data not available in the input.

Clinical Context

A 58-year-old hospitalized patient with severe community-acquired meningitis is treated with intravenous chloramphenicol after documented allergy to first-line agents and when susceptibility testing indicates limited alternatives. Due to chloramphenicol's narrow therapeutic index and risk of aplastic anemia and bone marrow suppression, the inpatient team requests a serum/plasma drug level to confirm therapeutic concentrations and avoid toxicity. The clinical workflow: medication is ordered and administered by the inpatient pharmacy and nursing staff; a timed blood draw (trough or peak depending on timing) is collected by phlebotomy and sent to the clinical laboratory; the laboratory analyst performs quantitative measurement of chloramphenicol on the serum/plasma sample, documents results in the lab information system, and communicates critical levels to the ordering clinician. Results guide ongoing dosing decisions, monitoring frequency, and hematologic surveillance.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the professional interpretation component if applicable in a lab-consult model.
`TC`	Technical component

Taxonomy Code	Specialty	Notes
207RH0000X	Infectious Disease	Infectious disease physicians order therapeutic drug monitoring for severe infections with atypical agents.
2080P0002X	Clinical Pathology	Pathologists and clinical chemists oversee laboratory testing and result validation.
163WL0400X	Hospitalist	Hospital medicine physicians commonly manage inpatients receiving off-label or high-risk antibiotics and order levels.
208000000X	Clinical Laboratory	Clinical laboratory scientists and directors manage assay performance and reporting.
207L00000X	Hematology	Hematologists may be involved due to chloramphenicol’s bone marrow toxicities.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G00.9`	Bacterial meningitis, unspecified	Chloramphenicol may be used when first-line agents are contraindicated or unavailable for severe central nervous system infections.
`J15.9`	Unspecified bacterial pneumonia	Severe pneumonia due to unusual pathogens or allergies to standard agents can prompt use and monitoring of chloramphenicol.
`A41.9`	Sepsis, unspecified organism	In refractory sepsis with limited antibiotic options, chloramphenicol levels may be measured to ensure efficacy and safety.
`T36.5X5A`	Adverse effect of other antibiotics, initial encounter	Used when monitoring is performed because of suspected toxicity from chloramphenicol.
`D61.9`	Aplastic anemia, unspecified	Relevant because chloramphenicol carries risk of aplastic anemia; monitoring and CBCs are clinically necessary.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`80053`	Comprehensive metabolic panel	Performed to monitor organ function (liver, kidney) when using potentially toxic antibiotics.
`85025`	Complete blood count (CBC) with automated differential	Used to monitor for bone marrow suppression during chloramphenicol therapy.
`80061`	Lipid panel	Not directly related; included in general inpatient monitoring panels when clinically indicated.
`36415`	Collection of venous blood by venipuncture	Supplies the serum/plasma specimen required for chloramphenicol level measurement.
`G0480`	Quantitative drug screening and confirmation, presumptive drug class not specified	Different methodology; referenced when broader drug level confirmation is needed.

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Summary & Overview