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Commonly Used Lab CPT codes by Pathology coders

Lab CPT codes are used very frequently by medical coders. For any test or screening, lab procedures are order and then the respective procedure Code is reported for payment. I have also worked for a little time in pathology facility, and I used most of the lab procedure codes. So, let use checkout today the most common lab CPT codes in medical coding.

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CPT code 36415-36416


In this procedure a needle is inserted into the skin over a vein to puncture the Blood vessel and withdraw blood for venous collection. For such procedure procedures CPT code 36415 is reported. For procedure code 36416, a prick is made into the finger, heel, or ear and capillary blood that pools at the puncture site is collected in a pipette. For both cases, the blood is used for diagnostic study and no catheter is placed.

Do not use modifier 63 in conjunction with 36415.

CPT code 36410, venipuncture necessitating physician's skill, is defined as a venipuncture for which the skill of a physician is required for diagnostic or therapeutic purposes.

Commonly Used Lab CPT codes by Pathology coders

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USe of CPT 80053 


This procedure codes comprises of different test. Hence it is named as Comprehensive Metabolic Panel. This panel includes the following tests: albumin (82040), total bilirubin (82247), total calcium (82310), carbon dioxide (bicarbonate) (82374), chloride (82435), creatinine (82565), glucose (82947), alkaline phosphatase (84075), potassium (84132), total protein (84155), sodium (84295), alanine amino transferase (ALT) (SGPT) (84460), aspartate amino transferase (AST) (SGOT) (84450), and urea nitrogen (BUN) (84520). Blood specimen is obtained by venipuncture. See the specific codes for additional information about the listed tests.


When to use CPT 83036-83037

83036- Hemoglobin; Glycosylated

83037- Hemoglobin; Glycosylated (A1C) by device cleared by FDA for home use

These procedures are also known as HbA1C. In these tests a blood specimen is collected. Glycosylated hemoglobin levels reflect the average level of glucose in the blood over a three-month period. These methods can also include use of high-performance liquid chromatography and ion exchange chromatography (83036) or FDA approved home monitoring device (83037).

82306 Vitamin D; 25 Hydroxy, Includes Fraction(s), If Performed

This test may be requested as 25-OHD3, 25(OH) Calciferol, Vitamin D 25-Hydroxy, Vitamin D3 25-OH, or Calciferol 25-Hydroxy. Specimen is serum or plasma and method is high performance liquid chromatography (HPLC), competitive protein binding (CPB), or radioimmunoassay (RIA). This code includes fractions, if performed.

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Use of code 84443 Thyroid Stimulating Hormone (TSH)

TSH is produced in the pituitary gland and stimulates the secretion of thyrotropin (T3) and thyroxine (T4); these secretory products monitor TSH. The specimen is serum, requiring special handling. Heel stick or umbilical cord sample is drawn from newborns and may be collected on a special paper. Methods may include radioimmunoassay (RIA), sandwich immunoradiometric assay (IRMA), fluorometric enzyme immunoassay with use of monoclonal antibodies, or microparticle enzyme immunoassay on IMx (MEIA). This test may be performed to determine thyroid function, to differentiate from various types of hypothyroidism (e.g., primary, and pituitary/hypothalamic), or to diagnose hyperthyroidism. The test may be ordered to evaluate therapy in patients receiving hypothyroid treatment, and to detect congenital hypothyroidism.

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When to use CPT code 80050 General Health Panel

A general health panel includes the following tests: albumin (82040), total bilirubin (82247), calcium (82310), carbon dioxide (bicarbonate) (82374), chloride (82435), creatinine (82565), glucose (82947), alkaline phosphatase (84075), potassium (84132), total protein (84155), sodium (84295), alanine amino transferase (ALT) (SGPT) (84460), aspartate amino transferase (AST) (SGOT) (84450), urea nitrogen (BUN) (84520), and thyroid stimulating hormone (84443). In addition, this panel includes a hemogram with automated differential (85025 or 85027 and 85004) or hemogram (85027) with manual differential (85007 or 85009). Blood specimen is obtained by venipuncture. See specific codes for additional information about the listed tests.

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80048 Basic Metabolic Panel, Calcium, Total

A basic metabolic panel with total calcium includes the following tests: total calcium (82310), carbon dioxide (82374), chloride (82435), creatinine (82565), glucose (82947), potassium (84132), sodium (84295), and urea nitrogen (BUN) (84520). The blood specimen is obtained by venipuncture. See the specific codes for additional information about the listed tests.

87491 Infectious Agent, Nucleic Acid (DNA/RNA); Chlamydia Trachomatis, Amplified Probe

This test may be requested as Chlamydia trachomatis or C. trachomatis by Polymerase Chain Reaction. C. trachomatis is a frequently occurring sexually transmitted disease. It may cause nonspecific urethritis or pelvic inflammatory disease (PID), although it is frequently asymptomatic in women. Another serotype also causes conjunctivitis. The DNA is amplified using a technique such as polymerase chain reaction (PCR).

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When to use CPT code 87086-87088

87086 Culture, Bacterial; Quantitative Colony Count, Urine

87087 Culture, Bacterial; w/Isolation & Presumptive ID Of Isolates, Urine

These codes report the performance of a urine bacterial culture with a calibrated inoculating device so that a colony count accurately correlates with the number of organisms in the urine. In 87088, isolation and presumptive identification of bacteria recovered from the sample is done by means of identifying colony morphology, subculturing organisms to selective media and the performance of a gram stain or other simple test to identify bacteria to the genus level. There are several automated systems that detect the presence of bacteria using colorimetric, radiometric, or spectrophotometric means. In 87086, quantified colony count numbers within the urine sample are measured.

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Use of CPT code 87491 Infectious Agent, Nucleic Acid (DNA/RNA); Chlamydia Trachomatis, Amplified Probe

This test may be requested as Chlamydia trachomatis or C. trachomatis by polymerase chain reaction. C. trachomatis is a frequently occurring sexually transmitted disease. It may cause nonspecific urethritis or pelvic inflammatory disease (PID), although it is frequently asymptomatic in women. Another serotype also causes conjunctivitis. The DNA is amplified using a technique such as polymerase chain reaction (PCR).

82962 Glucose, Blood, Glucose Monitoring Device(s) Cleared By FDA Specifically For Home Use

This test is used to monitor disorders of carbohydrate metabolism. This test reports blood glucose monitoring by an FDA-approved device. While the code states that it is for home use, these devices may also be used in the physician office. Blood is obtained by finger stick. Method is enzymatic, electrochemical, or spectrophotometry by small portable device designed for home glucose testing.

82607 Cyanocobalamin (Vitamin B-12)

This test may be requested as antipernicious anemia factor, true cyanocobalamin, or Vitamin B12. It is essential for red blood cell maturation and for gastrointestinal and neurologic health. Decreased levels may be indicative of certain anemias. Method is chemiluminescence, competitive protein binding (CPB) radioassay, or radioimmunoassay (RIA).

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When to use CPT code 84152-84154

84152 Prostate Specific Antigen (PSA); Complexed (Direct Measurement)

84153 Prostate Specific Antigen (PSA); Total

84154 Prostate Specific Antigen (PSA); Free

The specimen is serum. Methods may include radioimmunoassay (RIA) and monoclonal two-site immunoradiometric assay. These tests may be performed to determine the presence of cancer of the prostate, benign prostatic hypertrophy (BPH), prostatitis, post prostatectomy to detect residual cancer, and to monitor therapy. There are several forms of PSA present in serum. PSA may be complexed with the protease inhibitor alpha-1 antichymotrypsin (PSA-ACT). Complexed PSA is the most measurable form. PSA is also found in a free form. Free PSA is not complexed to a protease inhibitor. Higher levels of free PSA are more often associated with benign conditions of the prostate than with prostate cancer. Total PSA measures both complexed and free levels to provide a total amount present in the serum. A percentage of each form is sometimes calculated to distinguish benign from malignant conditions. Code 84152 reports complexed PSA; 84153 is for total serum PSA; 84154 is for free (not complexed) PSA.





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Commonly Used Lab CPT codes by Pathology coders

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