How To Use CPT Code 82107

CPT 82107 describes the measurement of alpha-fetoprotein (AFP) levels in the serum, including the AFP-L3 fraction isoform and the total AFP. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 82107?

CPT 82107 is used to measure the levels of alpha-fetoprotein (AFP) in the serum. This test also includes the measurement of the AFP-L3 fraction isoform and the calculation of the ratio between the total AFP and the AFP-L3 fraction. The AFP protein is primarily produced by liver cells in the fetus and is present in very low levels in individuals after the age of 12 months. The AFP-L3 fraction is a specific subset of AFP that has high specificity for hepatocellular carcinoma (HCC), a type of liver cancer. Clinicians often order the AFP-L3 ratio along with the total AFP test if they suspect liver cancer.

2. Official Description

The official description of CPT code 82107 is: ‘Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio).’ This code encompasses the measurement of both the AFP-L3 fraction isoform and the total AFP, as well as the calculation of the ratio between the two.

3. Procedure

1. The lab analyst performs the technical steps to measure the levels of AFP in the serum.
2. The analyst also measures the amount of the AFP-L3 fraction present in the sample.
3. The analyst calculates the ratio between the total AFP and the AFP-L3 fraction to provide additional information about the test results.
4. The measurement of AFP and the AFP-L3 fraction is typically done using an immunoassay with fluorescent labeling.
5. The analyst separates the different subsets of AFP using chromatography and provides a value for the total AFP and the AFP-L3 fraction.

4. Qualifying circumstances

CPT 82107 is typically ordered by clinicians for three main reasons:

• Screening for neural tube disorders in pregnant women between gestational weeks 14 to 22.
• Screening for liver disorders such as cirrhosis or hepatitis, as well as monitoring the patient’s response to treatment for these conditions.
• Screening for certain types of cancers, including testicular cancer, hepatocellular carcinoma (HCC), and malignant teratoma.

5. When to use CPT code 82107

CPT code 82107 should be used when measuring the levels of AFP in the serum, including the AFP-L3 fraction isoform and the total AFP. This code is appropriate for screening purposes, monitoring treatment response, and detecting certain types of cancers. It should not be used for other types of AFP testing, such as amniotic fluid testing or testing for specific conditions like spina bifida or Down syndrome.

6. Documentation requirements

To support a claim for CPT code 82107, the following documentation is required:

• Patient’s demographic information
• Date of the test
• Results of the AFP measurement
• Results of the AFP-L3 fraction measurement
• Calculation of the ratio between the total AFP and the AFP-L3 fraction
• Interpretation of the test results
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT code 82107, ensure that the test includes the measurement of both the AFP-L3 fraction isoform and the total AFP, as well as the calculation of the ratio. It is important to follow the specific guidelines provided by the payer regarding the appropriate use of this code and any additional documentation requirements. It is also important to note that some payers may separately reimburse for the collection of the specimen using a different code, such as 36415 for venous blood collection.

8. Historical information

CPT code 82107 was added to the Current Procedural Terminology system on January 1, 2007. There have been no updates or changes to the code since its addition.

9. Examples

1. A pregnant woman undergoing AFP testing between gestational weeks 14 to 22 to screen for neural tube disorders in her unborn infant.
2. A patient with suspected liver cancer undergoing AFP testing to measure the AFP-L3 ratio and monitor the progression of the disease.
3. A patient with cirrhosis or hepatitis undergoing AFP testing to assess the response to treatment.
4. A patient with testicular cancer undergoing AFP testing to monitor the effectiveness of chemotherapy.
5. A patient with a history of malignant teratoma undergoing AFP testing for surveillance purposes.