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Assign Laboratory Panel Codes - Certified Professional Coder CPC

  1. A physician orders a comprehensive metabolic panel (CMP) that includes glucose, calcium, albumin, total protein, sodium, potassium, CO2, chloride, BUN, creatinine, alkaline phosphatase, ALT, AST, and bilirubin. Which CPT® code covers the comprehensive metabolic panel?
    Answer: 80053 CPT® 80053 covers the comprehensive metabolic panel (CMP), which includes 14 analytes: glucose, calcium, albumin, total protein, sodium, potassium, CO2, chloride, BUN, creatinine, alkaline phosphatase, ALT, AST, and total bilirubin. Code 80047 covers the basic metabolic panel with ionized calcium; 80048 covers the basic metabolic panel with total calcium; 80076 covers the hepatic function panel. When all 14 CMP components are performed, 80053 is reported rather than individual analyte codes.
  2. A clinic performs an automated urinalysis without microscopy on a urine specimen. Which CPT® code covers automated urinalysis without microscopy?
    Answer: 81003 CPT® 81003 covers urinalysis, by dip stick or tablet reagent, automated, without microscopy. Code 81001 covers non-automated urinalysis with microscopy; 81000 covers non-automated urinalysis without microscopy; 81002 covers non-automated urinalysis without microscopy (a related non-automated variant). Automated urinalysis without microscopy is the most common urine dipstick test in a clinical setting and is coded with 81003.
  3. A physician orders a lipid panel including total cholesterol, HDL cholesterol, triglycerides, and LDL cholesterol. Which CPT® code covers the complete lipid panel?
    Answer: 80061 CPT® 80061 covers the lipid panel, which includes total cholesterol (82465), HDL cholesterol (83718), and triglycerides (84478) — from which LDL is typically calculated. When all three components are ordered together, 80061 is reported instead of the individual analyte codes. Reporting individual codes when a panel code exists for the same combination constitutes unbundling.
  4. A diabetic patient has a hemoglobin A1c (HbA1c) test performed for long-term glucose monitoring. Which CPT® code covers HbA1c testing?
    Answer: 83036 CPT® 83036 covers hemoglobin A1c (glycosylated hemoglobin). Code 82985 covers glycated protein (fructosamine), which reflects shorter-term glycemic control than HbA1c; 84295 covers sodium; 84439 covers thyroxine, total (T4). HbA1c (83036) reflects average blood glucose over the prior 2-3 months and is the standard test for diabetes management and long-term monitoring. It is distinct from fasting glucose and from the glycated protein (fructosamine) test.
  5. A physician orders a prostate-specific antigen (PSA) test for prostate cancer screening. Which CPT® code covers total PSA testing?
    Answer: 84153 CPT® 84153 covers prostate specific antigen (PSA), total — the standard screening test for prostate cancer detection and monitoring. Code 84154 covers PSA, free (reported when the ratio of free-to-total PSA is calculated for risk stratification); 86316 covers immunoassay for tumor antigen, other, non-PSA-specific; 86294 covers immunoassay for tumor antigen, qualitative. For PSA screening, 84153 (total PSA) is the correct code, not the free PSA code (84154).
  6. A patient with acute chest pain has a troponin I test ordered in the emergency department for quantitative measurement. Which CPT® code covers troponin, quantitative?
    Answer: 84484 CPT® 84484 covers troponin I or T, quantitative — the appropriate code for a laboratory-based quantitative troponin assay. Code 82553 covers myoglobin, quantitative; 82554 covers myoglobin, qualitative; 84485 covers xylose absorption test. Quantitative troponin testing (84484) is the standard assay for ruling in or ruling out acute myocardial injury. The distinction between quantitative and qualitative troponin testing is clinically important for choosing the correct code.
  7. A patient with suspected heart failure has a B-type natriuretic peptide (BNP) test ordered to assess cardiac function. Which CPT® code covers BNP testing?
    Answer: 83880 CPT® 83880 covers natriuretic peptide (BNP). Code 83882 covers natriuretic peptide, NT-pro (N-terminal pro-BNP), a related but distinct assay; 83519 covers immunoassay for analyte other than antibody, quantitative (a non-specific immunoassay code); 83090 covers homocysteine. BNP (83880) and NT-proBNP (83882) are used to diagnose and monitor heart failure, but they are not interchangeable codes. The specific peptide tested determines the code.
  8. A physician orders a thyroid stimulating hormone (TSH) test to screen for thyroid dysfunction. Which CPT® code covers TSH testing?
    Answer: 84443 CPT® 84443 covers thyroid stimulating hormone (TSH). Code 84436 covers thyroxine, total (T4); 84439 covers thyroxine, free (FT4); 84445 covers thyroid stimulating immunoglobulin (TSI). TSH (84443) is the first-line screening test for thyroid dysfunction and is distinct from the thyroxine (T4/FT4) and TSI codes. Accurate selection requires knowing whether TSH, T4, FT4, or TSI is being ordered.
  9. A physician orders a complete blood count (CBC) without differential. Which CPT® code covers CBC without differential?
    Answer: 85027 CPT® 85027 covers blood count, complete (CBC), automated (Hgb, Hct, RBC, WBC, and platelet count) — without differential. Code 85025 covers CBC with automated differential; 85007 covers differential WBC count, manual; 85014 covers hematocrit only. When a CBC is ordered without a differential WBC count, 85027 is reported. The with/without differential distinction is the key differentiator between 85025 (with diff) and 85027 (without diff).
  10. A urine culture is performed on a UTI specimen, and the laboratory performs both quantitative colony count and presumptive identification of the isolated organism. Which CPT® code covers bacterial urine culture with presumptive identification of isolates?
    Answer: 87088 CPT® 87088 covers culture, bacteria, urine, with presumptive identification of isolates — reported when the laboratory both quantifies the colony count and identifies the organism(s) isolated. Code 87086 covers quantitative urine culture (colony count only, without organism identification); 87040 covers blood culture; 87045 covers stool culture for specific organisms. When presumptive identification is performed in addition to the quantitative count, 87088 is reported instead of, or in addition to, 87086, depending on the method and documentation.
  11. A physician performs a rapid antigen detection test for Group A streptococcal pharyngitis (rapid strep test) in the office. Which CPT® code covers rapid strep antigen detection by immunoassay with direct optical observation?
    Answer: 87880 CPT® 87880 covers infectious agent antigen detection by immunoassay with direct optical (visual) observation, streptococcus, group A — the standard code for an office-based rapid strep test. Code 86403 covers particle agglutination, screen; 86588 covers streptococcal antibody detection (an older serology code, not a rapid antigen test); 87070 covers bacterial culture (a different method). For the standard office rapid strep immunoassay with visual reading, 87880 is the correct and specific code.
  12. A clinician performs a manual urinalysis with microscopy to evaluate for casts, cells, and bacteria. Which CPT® code covers urinalysis with microscopy?
    Answer: 81001 CPT® 81001 covers urinalysis by dip stick or tablet reagent, non-automated, with microscopy. Code 81000 covers non-automated urinalysis without microscopy; 81002 covers non-automated urinalysis without microscopy (dipstick only); 81003 covers automated urinalysis without microscopy. When microscopy is performed as part of the urinalysis to evaluate cells, casts, and organisms, 81001 (non-automated, with microscopy) is the correct code.
  13. A physician orders a partial thromboplastin time (PTT) to monitor unfractionated heparin therapy. Which CPT® code covers PTT?
    Answer: 85730 CPT® 85730 covers partial thromboplastin time (PTT or aPTT) — the standard test for monitoring unfractionated heparin anticoagulation. Code 85610 covers prothrombin time (PT/INR, used for warfarin monitoring); 85613 covers Russell viper venom time; 85732 covers PTT substitution tests. The PTT (85730) and PT (85610) serve different clinical purposes: PTT monitors heparin, PT monitors warfarin. Accurate code selection requires knowing which anticoagulant is being monitored.
  14. A physician orders only glucose, BUN, and creatinine individually — three components from the basic metabolic panel. Should the BMP panel code (80048) be reported instead of the three individual codes?
    Answer: No — a panel code is reported only when ALL components of that panel are performed CPT® coding guidelines state that a panel code is reported only when all of the tests included in that panel are performed. If only some components of a panel are ordered, the individual test codes are reported separately — the panel code is not reported. Ordering glucose, BUN, and creatinine (3 of the 8 BMP components) does not support reporting 80048. Additionally, unbundling rules prohibit separately reporting individual analyte codes when a complete panel was performed — the panel code must be used when all components are done.
  15. A physician orders a hepatic function panel including total protein, albumin, total bilirubin, direct bilirubin, alkaline phosphatase, ALT, and AST. Which CPT® code covers the hepatic function panel?
    Answer: 80076 CPT® 80076 covers the hepatic function panel, which includes albumin, bilirubin (direct), bilirubin (total), alkaline phosphatase, protein (total), AST, and ALT. Code 80053 covers the comprehensive metabolic panel (which also includes some of these analytes but adds renal function tests and electrolytes); 80048 covers the basic metabolic panel; 80061 covers the lipid panel. When liver function tests are ordered as a group meeting the panel definition, 80076 is reported.
  16. A physician orders a basic metabolic panel (BMP) including glucose, calcium (total), sodium, potassium, CO2, chloride, BUN, and creatinine. Which CPT® code covers the basic metabolic panel with total calcium?
    Answer: 80048 CPT® 80048 covers the basic metabolic panel with total calcium — 8 analytes including glucose, calcium (total), sodium, potassium, CO2, chloride, BUN, and creatinine. Code 80047 covers the BMP with ionized calcium instead of total calcium; 80053 covers the full comprehensive metabolic panel (14 tests); 80050 covers the general health panel. The distinction between total calcium (80048) and ionized calcium (80047) in the BMP is clinically and coding-significant.
  17. A urine culture grows E. coli, and antibiotic susceptibility testing using the disk diffusion (Kirby-Bauer) method is performed to guide antibiotic selection. Which CPT® code covers antimicrobial susceptibility testing by disk method?
    Answer: 87184 CPT® 87184 covers susceptibility studies, antimicrobial agent; disk method (Kirby-Bauer), per plate — the standard code for disk diffusion susceptibility testing. Code 87186 covers susceptibility by microdilution or agar dilution (MIC), each agent; 87181 covers susceptibility by enzyme inactivation method; 87188 covers susceptibility by macrotube dilution. The disk diffusion (Kirby-Bauer) method, which places antibiotic-impregnated disks on an agar plate with the organism, is specifically reported with 87184.
  18. A physician orders a general health panel for a new patient annual examination. The general health panel includes a comprehensive metabolic panel, CBC with differential, and TSH. Which CPT® code covers the general health panel?
    Answer: 80050 CPT® 80050 covers the general health panel, which includes comprehensive metabolic panel (80053), CBC with automated differential (85025), and TSH (84443). Code 80053 covers the CMP alone; 80048 covers the basic metabolic panel; 80076 covers the hepatic function panel. When all components of the general health panel are ordered together, 80050 is reported instead of reporting each component individually. Reporting 80053, 85025, and 84443 separately when all were performed together would constitute unbundling.
  19. A pregnant patient in the first trimester undergoes an obstetric panel. Which CPT® code covers the standard obstetric panel?
    Answer: 80055 CPT® 80055 covers the obstetric panel, which includes CBC with differential, hepatitis B surface antigen, antibody screen (RBC), rubella antibody, syphilis test (ABO), and antibody to HIV-1. Code 80081 covers an obstetric panel that includes HIV-1 antibody testing as a defined component; 80050 covers the general health panel; 80053 covers the comprehensive metabolic panel. The standard first-trimester obstetric panel is 80055.
  20. A patient on warfarin therapy undergoes a prothrombin time (PT) with INR calculation. Which CPT® code covers PT with INR?
    Answer: 85610 CPT® 85610 covers prothrombin time (PT), which includes the INR calculation when performed. Code 85613 covers Russell viper venom time (dilute); 85730 covers partial thromboplastin time (PTT or aPTT), used for heparin monitoring; 85732 covers PTT substitution tests. For warfarin monitoring, the PT/INR (85610) is the standard test. The PT and PTT serve different clinical purposes and monitor different anticoagulants.

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