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Pathology/Lab Coding Alert

Reader Question:

Justify 82310 and 82330 Together

Published on Mon Sep 10, 2012

Question: An endocrinologist client sometimes orders total calcium and ionized calcium together for the diagnosis of hyperparathyroidism. Can we code for both tests?Texas SubscriberAnswer: Yes, you can bill together 82310 (Calcium; total) and 82330 (... ionized) if your lab performs both tests. There are no Correct Coding Initiative (CCI) edits that restrict billing these two codes together.Caution: The physician will need to demonstrate medical necessity for ordering both tests. Although elevated total calcium is a common indicator of possible hyperparathyroidism, some studies point to ionized calcium as a more discriminating indicator, especially for borderline hyperparathyroidism. Parathyroid hormone, produced by the parathyroid glands, controls calcium, phosphorus and vitamin D levels in the blood. Primary hyperparathyroidism occurs when an enlarged parathyroid gland leads to too much hormone, which raises the level of calcium in the blood.
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