How To Use CPT Code 82043
CPT 82043 is a code used for the quantitative measurement of albumin in urine, which helps in diagnosing and treating kidney diseases. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 82043.
1. What is CPT 82043?
CPT 82043 is a code used in the medical field for the quantitative measurement of albumin in urine samples. This test is essential for diagnosing and treating patients with kidney diseases, as it helps detect the presence of occult kidney disease and monitor patients with previously documented microalbumin in their urine. The test is often abbreviated as MALB and is frequently ordered as a microalbumin/creatinine ratio (MCR).
2. 82043 CPT code description
The official description of CPT code 82043 is: “Albumin; urine (eg, microalbumin), quantitative.”
3. Procedure
- The lab analyst collects a timed or random urine specimen from the patient.
- The specimen is then analyzed using colorimetric or nephelometric methodologies to measure the albumin levels.
- Reagents are added to the specimen, and the absorbance or turbidity (clarity) is measured and reported.
- If ordered as a microalbumin/creatinine ratio (MCR), the lab analyst will also quantitatively measure the urine creatinine using code 82570 and calculate the microalbumin/creatinine ratio.
- The results are then reported to the healthcare provider for further evaluation and treatment planning.
4. Qualifying circumstances
Patients who are eligible to receive CPT code 82043 services are those who are suspected of having kidney diseases or are being monitored for previously documented microalbumin in their urine. This test is particularly useful for detecting early kidney disease and monitoring protein loss from the kidney due to reduced kidney function.
5. When to use CPT code 82043
It is appropriate to bill the 82043 CPT code when a healthcare provider orders a quantitative urine albumin test for a patient suspected of having kidney disease or for monitoring patients with previously documented microalbumin in their urine. The test can also be billed when ordered as a microalbumin/creatinine ratio (MCR) to assess protein loss from the kidney due to reduced kidney function.
6. Documentation requirements
To support a claim for CPT 82043, the following information needs to be documented:
- Patient’s medical history and symptoms indicating the need for a urine albumin test.
- Physician’s order for the urine albumin test or microalbumin/creatinine ratio (MCR).
- Details of the specimen collection, including the date and time of collection.
- Methodology used for the analysis, such as colorimetric or nephelometric.
- Results of the urine albumin test or microalbumin/creatinine ratio (MCR), including the measured values and any relevant calculations.
- Interpretation of the results by the healthcare provider and any subsequent treatment plans or recommendations.
7. Billing guidelines
When billing for CPT code 82043, it is essential to follow the appropriate guidelines and rules. Some tips and codes that apply to CPT code 82043 include:
- For semiquantitative urine albumin, use code 82044 instead of 82043.
- If the performing lab is a CLIA waived facility, append modifier QW to the billing code for tests listed as CLIA waived tests by CMS.
- Ensure that all documentation requirements are met to support the claim for CPT 82043.
8. Historical information
CPT 82043 was added to the Current Procedural Terminology system on January 1, 1993. The code was changed on January 1, 2018, with the previous descriptor being “Albumin; urine, microalbumin, quantitative.”
9. Similar codes to CPT 82043
Five similar codes to CPT 82043 and how they differentiate from CPT 82043 are:
- CPT 82044: This code is used for semiquantitative urine albumin tests, whereas CPT 82043 is for quantitative tests.
- CPT 82570: This code is used for the quantitative measurement of creatinine in urine, which is often ordered alongside CPT 82043 for the microalbumin/creatinine ratio (MCR).
- CPT 84156: This code is for the quantitative measurement of serum or plasma albumin, whereas CPT 82043 is for urine albumin.
- CPT 82040: This code is for the quantitative measurement of serum albumin, whereas CPT 82043 is for urine albumin.
- CPT 82042: This code is for the quantitative measurement of albumin in other body fluids, whereas CPT 82043 is for urine albumin.
10. Examples
Here are 10 detailed examples of CPT code 82043 procedures:
- A patient with a family history of kidney disease presents with symptoms of fatigue and swelling in the legs. The healthcare provider orders a quantitative urine albumin test (CPT 82043) to assess the patient’s kidney function.
- A patient with diabetes undergoes routine screening for kidney disease using a quantitative urine albumin test (CPT 82043).
- A patient with hypertension is monitored for kidney damage using a microalbumin/creatinine ratio (MCR) test, which includes CPT 82043 for the quantitative measurement of urine albumin and CPT 82570 for urine creatinine.
- A patient with a history of kidney stones undergoes a quantitative urine albumin test (CPT 82043) to assess their kidney function and detect any potential damage.
- A patient with lupus is monitored for kidney involvement using a quantitative urine albumin test (CPT 82043).
- A patient with a urinary tract infection undergoes a quantitative urine albumin test (CPT 82043) to assess the impact of the infection on their kidney function.
- A patient with chronic kidney disease is monitored for disease progression using a microalbumin/creatinine ratio (MCR) test, which includes CPT 82043 for the quantitative measurement of urine albumin and CPT 82570 for urine creatinine.
- A patient undergoing treatment for kidney disease has a follow-up quantitative urine albumin test (CPT 82043) to assess the effectiveness of the treatment.
- A patient with a kidney transplant undergoes routine monitoring of their kidney function using a quantitative urine albumin test (CPT 82043).
- A patient with preeclampsia undergoes a quantitative urine albumin test (CPT 82043) to assess the impact of the condition on their kidney function.