How To Use CPT Code 82746

CPT 82746 refers to the measurement of folic acid levels in serum to determine deficiencies. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT code 82746.

1. What is CPT 82746?

CPT 82746 is a code used to represent the laboratory procedure for measuring folic acid levels in serum. This test is primarily ordered by clinicians to detect deficiencies in folic acid, a B-vitamin essential for normal red blood cell production. Folic acid deficiency can be caused by various factors, including malabsorption, surgical treatments for obesity, pregnancy, and other conditions.

2. 82746 CPT code description

The official description of CPT code 82746 is: “Folic acid; serum.”

3. Procedure

The 82746 procedure involves the following steps:

  1. A blood sample is collected from the patient, typically through venipuncture.
  2. The serum is separated from the blood sample using a centrifuge.
  3. The lab analyst measures the folic acid level in the serum sample using a technique such as radioimmunoassay, which involves a gamma-radioactive tagged isotope and a gamma counter for precise measurement.
  4. The results are interpreted by the clinician to determine if the patient has a folic acid deficiency and to guide further treatment or management.

4. Qualifying circumstances

Patients eligible to receive CPT code 82746 services are those who present with symptoms or conditions that may indicate a folic acid deficiency. These may include:

  • Anemia or megaloblastic anemia
  • Malabsorption disorders, such as Crohn’s disease or celiac sprue
  • Previous bypass surgical procedures that reduce absorption
  • Pregnancy
  • Other conditions that may affect folic acid levels, such as alcoholism or certain medications

5. When to use CPT code 82746

It is appropriate to bill the 82746 CPT code when a clinician orders a serum folic acid test to evaluate a patient’s folic acid levels due to suspected deficiency. This test may be ordered as part of a broader diagnostic workup or to monitor the effectiveness of treatment for a known folic acid deficiency.

6. Documentation requirements

To support a claim for CPT 82746, the following information should be documented:

  • Patient’s medical history and presenting symptoms or conditions that warrant the folic acid test
  • Clinician’s order for the serum folic acid test
  • Details of the blood sample collection, including date, time, and method (e.g., venipuncture)
  • Results of the folic acid test, including the measured serum folic acid level and reference range
  • Clinician’s interpretation of the test results and any subsequent treatment or management recommendations

7. Billing guidelines

When billing for CPT code 82746, it is essential to follow the specific guidelines and rules set by the payer. Some payers may reimburse separately for the specimen collection using a code such as 36415 for venipuncture. Additionally, clinicians may order other related tests, such as CPT code 82747 for RBC folic acid or CPT code 82607 for B-12 (cyanocobalamin), which should be billed separately.

8. Historical information

CPT 82746 was added to the Current Procedural Terminology system on January 1, 1990. There have been no significant updates to this code since its addition.

9. Similar codes to CPT 82746

Five similar codes to CPT 82746 and how they differ are:

  • CPT 82747: This code is for the measurement of folic acid levels in red blood cells (RBC) instead of serum.
  • CPT 82607: This code represents the measurement of vitamin B-12 (cyanocobalamin) levels, which is often ordered alongside folic acid testing.
  • CPT 82652: This code is for the measurement of active vitamin B-12 (holotranscobalamin) levels.
  • CPT 83090: This code is for the measurement of homocysteine levels, which can be related to folic acid and vitamin B-12 deficiencies.
  • CPT 83921: This code is for the measurement of methylmalonic acid levels, another marker related to vitamin B-12 deficiency.

10. Examples

Here are 10 detailed examples of CPT code 82746 procedures:

  1. A patient with unexplained fatigue and pallor undergoes a serum folic acid test to evaluate for anemia caused by folic acid deficiency.
  2. A pregnant woman has a serum folic acid test to ensure adequate folic acid levels for fetal development.
  3. A patient with a history of alcoholism undergoes a serum folic acid test to assess potential nutritional deficiencies.
  4. A patient with Crohn’s disease has a serum folic acid test to monitor folic acid levels due to malabsorption.
  5. A patient who has undergone gastric bypass surgery has a serum folic acid test to evaluate potential nutrient deficiencies.
  6. A patient on long-term anticonvulsant medication undergoes a serum folic acid test to monitor potential drug-induced folic acid deficiency.
  7. A patient with macrocytic anemia has a serum folic acid test to determine if folic acid deficiency is the cause.
  8. A patient with a history of celiac disease undergoes a serum folic acid test to assess folic acid levels due to potential malabsorption.
  9. A patient with unexplained neurological symptoms has a serum folic acid test as part of a broader diagnostic workup.
  10. A patient receiving folic acid supplementation for a known deficiency undergoes a serum folic acid test to monitor the effectiveness of treatment.

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