How To Use CPT Code 82438

CPT 82438 describes the measurement of chloride in the cerebrospinal fluid (CSF), sweat, or another source other than blood or urine. 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 82438?

CPT 82438 can be used to measure the amount of chloride in the cerebrospinal fluid (CSF), sweat, or another source other than blood or urine. Chloride is an important ion that helps maintain the electrolyte balance in the body. This code is used when a lab analyst quantitatively measures the chloride using an ion selective electrode method.

2. Official Description

The official description of CPT code 82438 is: ‘Chloride; other source.’

3. Procedure

1. The lab analyst uses an ion selective electrode method to quantitatively measure the chloride in the cerebrospinal fluid (CSF), sweat, or another source other than blood or urine.
2. The method involves using a sensitive potentiometer to measure the voltage from a transducer, which converts the electric potential of a single ion to determine the amount of chloride in the solution.
3. For sweat chloride measurement, the clinician or lab analyst may use iontophoresis to induce sweating using the drug pilocarpine and collect the sweat for analysis.

4. Qualifying circumstances

CPT 82438 is used when measuring chloride in the cerebrospinal fluid (CSF), sweat, or another source other than blood or urine. This test is commonly ordered for patients with cystic fibrosis, as they may have elevated chloride levels. The lab analyst performs the testing using the ion selective electrode method.

5. When to use CPT code 82438

CPT code 82438 should be used when there is a need to measure chloride in the cerebrospinal fluid (CSF), sweat, or another source other than blood or urine. It is important to use this code when the lab analyst performs the testing using the ion selective electrode method. This code should not be used for blood chloride (CPT 82435), urine chloride (CPT 82436), or sweat collection by iontophoresis (CPT 89230).

6. Documentation requirements

To support a claim for CPT 82438, the documentation should include:

• Indication for the test and the source of the sample (CSF, sweat, or other)
• Method used for measuring chloride (ion selective electrode)
• Date and time of the test
• Results of the chloride measurement
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 82438, ensure that the test is performed by a lab analyst using the ion selective electrode method. It is important to use this code specifically for measuring chloride in the cerebrospinal fluid (CSF), sweat, or another source other than blood or urine. Do not report CPT 82438 if you are performing blood chloride (CPT 82435), urine chloride (CPT 82436), or sweat collection by iontophoresis (CPT 89230).

8. Historical information

CPT 82438 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst measuring chloride in the cerebrospinal fluid (CSF) of a patient with suspected electrolyte imbalance.
2. A clinician ordering sweat chloride measurement using iontophoresis for a patient with suspected cystic fibrosis.
3. A lab analyst quantitatively measuring chloride in a sample from a source other than blood or urine for research purposes.
4. A patient undergoing sweat chloride testing to monitor the effectiveness of their cystic fibrosis treatment.
5. A lab analyst performing chloride measurement in the cerebrospinal fluid (CSF) to assist in diagnosing a neurological disorder.
6. A clinician ordering sweat chloride testing for a newborn baby with symptoms suggestive of cystic fibrosis.
7. A lab analyst measuring chloride in a sample from a non-traditional source, such as saliva or tears, for a specialized research study.
8. A patient undergoing sweat chloride testing as part of a comprehensive evaluation for an electrolyte imbalance.
9. A lab analyst quantitatively measuring chloride in the cerebrospinal fluid (CSF) to monitor the progress of a patient with a known neurological condition.
10. A clinician ordering sweat chloride measurement for a patient with recurrent respiratory infections and suspected cystic fibrosis.