Pathology/Lab Coding Alert

Question: The lab received an order for blood levels of the following components: albumin, total calcium, chloride, creatinine, glucose, phosphate, potassium, sodium, BUN, and pH.

Should I bill this as a renal function panel, plus pH?

Maine Subscriber

Answer: No, you should not bill this as 80069 (Renal function panel), because you’re missing one of the components of that test — carbon dioxide (bicarbonate).

Instead, you should bill each test individually as follows:

• Albumin, 82040
• Total calcium, 82310
• Chloride, 82435
• Creatinine, 82565
• Glucose, 82947
• Phosphorus inorganic (phosphate), 84100
• Potassium, 84132
• Sodium, 84295
• Urea nitrogen (BUN), 84520
• pH, 82800 

‘Not clinical parameters’: CPT^® instruction states that the AMA developed the panels for coding purposes only, not as an indicator of what physicians “should” order. The physician decides which tests are medically necessary, and you should code what the physician orders and the lab performs.

Rule: You should report a code from the “Organ or Disease Oriented Panels” section (80047-80081) only when the lab performs each component of one of the panels.