Question 82044/82570

Rebecca Pate

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Columbus GA
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My question is, if "microalbumin/creatinine" is ordered and done, should both codes (82044 & 82570) be billed? A coworker (who is a biller and worked here longer) is telling me to only bill the 82044. I just want to verify, as it looks to me as if both should be billed.
I appreciate any insight I can get.
 

danachock

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Brainerd, MN
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Hi Rebecca,

Thank you for posting this question. Procedure 82044 is a urine specimen so I may have a little information on this to provide insight for proper procedural coding. First I reviewed my CPT book and then reviewed our facility's lab catalog. It states in my 2019 CPT Professional 2019 from AMA starting on the bottom right hand corner of page 583 and flows to the upper left hand corner on page 584 that -

"The material for examination may be from any source unless otherwise specified in the code descriptor. When an analyte is measured in multiple specimens from different sources, or in specimens that are obtained at the different times, the analyte is reported separately for each source and for each specimen. The examination is quantitative unless specified......

Clinical information or mathematically calculated values, which are not specifically requested by the ordering physician and are derived from the results of other ordered or performed laboratory tests, are considered part of of the ordered test procedure(s). and therefore are not separately reportable service(s).

When the requested analyte result is derived using a calculation that requires values from nonrequested laboratory analyses, only the requested analte code should be reported.

When the calculated analyte determination requires values driven from other requested and nonrequested laboratory analyses, the requested analyte codes (including those calculated) should be reported.

AN EXCEPTION TO THE ABOVE....... is when an analyte (eg, urinary creatinine) is performed to compensate for variations in urine concentration (eg. microalbumin, thromboxane, metabolites) in random urine samples; the appropriate CPT code is reported for both the ordered analyte and the additional required analyte. When the calculated result(s) represent an algorithmically derived numeric score or probability, see the appropriate multianalyte assay with algorithim analyses (MAAA) code or the MAAA unlisted code 81599."

Based on this information I am providing "when the calculated determination requires values driven from other requested or non requested information, the requested analyte code(s) including those calculated should be reported." In the case of a urine sample I would feel comfortable billing both codes based on what the CPT book has simply provided, unless someone else has documentation to state otherwise ~ if so please share. If the provider was only concerned about the creatinine (urine) they would have simply ordered it but per your posting it states "microalbumin/creatinine"; instead the provider provided a lab order requesting both the creatinine and microalbumin to simply be performed from urine (my pure speculation from your post stating 82044 was being applied). With CPT book in hand and your limited information - I would feel comfortable billing both procedure 82044 with 82570.

Thanks for listening,
Dana Chock, RHIT, CPC, CANPC, CHONC, CPMA, CPB
Coding Analyst (May 2018 - present), Pathology & Laboratory Coder (Fall 2012-May 2018), Anesthesia Coder (April 2013-May 2018)
 
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