Pathology/Lab Coding Alert

Question: We do the same lab test for 82947, 82950, 82951, and 82952 -- is the number of glucose tests the only difference in the codes?

Mississippi Subscriber

Answer: No, the number of glucose tests is not all that distinguishes the following codes:

• 82947 -- Glucose; quantitative, blood (except reagent strip)
• 82948 -- ... blood, reagent strip
• 82950 -- ... post glucose dose (includes glucose)
• 82951 -- ... tolerance test (GTT), 3 specimens (includes glucose)
• 82952 -- ... tolerance test, each additional beyond 3 specimens

Does patient consume glucose? If the lab receives a fasting blood sample with no indication that the patient consumed a glucose dose, you should select 82947 or 82948, depending on the lab method. If the lab runs multiple glucose tests on the same day with no evidence of a glucose dose, you should report multiple units of either 82947 or 82948. Depending on the payer, you might need to append modifier 91 (Repeat clinical diagnostic laboratory test).

On the other hand, if the patient consumes glucose dose(s), you should select either 82950 or 82951, as follows:

Report 82950 for a "post glucose challenge" test that involves one glucose dose and a subsequent blood glucose measurement.

Use 82951 for a "glucose tolerance test" that involves a baseline fasting glucose test followed by two glucose doses and subsequent blood glucose measurements.

List 82952 in addition to 82951 for each glucose dose and test beyond the initial three included in 82951. In fact, CPT 2011 adds this instruction to the 82952 code definition: List separately in addition to code for primary procedure. You should not use 82947 for additional glucose measures as part of a GTT.

Opportunity: Although 82951 includes the baseline glucose test, 82950 does not. If the physician orders a fasting glucose followed by a post glucose dose, you can bill 82947 and 82950 together.

Don't let the phrase "includes glucose" in codes 82950 and 82951 fool you -- that doesn't mean the code includes a fasting blood glucose test. "Includes glucose" means that the code includes the cost of the glucose the patient consumes before taking the blood specimen.