How To Use CPT Code 82728

CPT 82728 is a code used for measuring the level of ferritin in serum, which helps clinicians diagnose various conditions related to iron levels in the body. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 82728.

1. What is CPT 82728?

CPT 82728 is a code used to represent the laboratory procedure for measuring the level of ferritin in serum. Ferritin is an important protein that contains approximately 20% iron and acts as an iron reserve in the body. It is present in minute quantities in serum but reflects the iron stores in the body. Clinicians use ferritin levels to distinguish between iron deficiency anemia and anemia of chronic disease, as well as to identify hemochromatosis, a condition of iron overload.

2. 82728 CPT code description

The official description of CPT code 82728 is: “Ferritin.”

3. Procedure

The procedure for CPT 82728 involves the following steps:

1. Collection of a blood sample from the patient.
2. Separation of serum from the blood sample using a centrifuge.
3. Quantitation of ferritin in the serum using an immunoassay technique, which involves an antigen-antibody response to measure the analyte.
4. Analysis and interpretation of the results by a laboratory professional.
5. Reporting of the ferritin level to the ordering clinician.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 82728 services include those who:

• Are experiencing symptoms of anemia, such as fatigue, weakness, or pallor.
• Have a history of iron deficiency or iron overload.
• Are undergoing evaluation for conditions that may affect iron levels, such as chronic kidney disease, liver disease, or inflammatory disorders.
• Require monitoring of iron levels during treatment for iron deficiency or iron overload.

5. When to use CPT code 82728

It is appropriate to bill the 82728 CPT code when a clinician orders a ferritin test to:

• Diagnose or rule out iron deficiency anemia or anemia of chronic disease.
• Identify hemochromatosis or other conditions of iron overload.
• Monitor iron levels during treatment for iron deficiency or iron overload.
• Evaluate the patient’s iron status in the context of other medical conditions or treatments that may affect iron levels.

6. Documentation requirements

To support a claim for CPT 82728, the following information should be documented:

• The patient’s relevant medical history, including any previous diagnoses or treatments related to iron levels.
• The patient’s presenting symptoms or clinical findings that warrant the ferritin test.
• The ordering clinician’s rationale for ordering the ferritin test, including the specific clinical question(s) to be answered.
• The results of the ferritin test, including the laboratory’s reference range for normal ferritin levels.
• Any additional tests or treatments that were ordered based on the ferritin test results.

7. Billing guidelines

When billing for CPT code 82728, keep in mind the following guidelines and tips:

• Ensure that the documentation supports the medical necessity of the ferritin test for the specific patient.
• Verify that the patient’s insurance plan covers the ferritin test, as some plans may have restrictions or limitations on coverage for laboratory tests.
• Be aware of any applicable coding modifiers, such as -59 for a distinct procedural service, that may be required to accurately represent the services provided.
• Consider bundling the ferritin test with other related laboratory tests, such as serum iron (CPT 83540) and iron binding capacity (CPT 83550), if they are ordered concurrently.

8. Historical information

CPT 82728 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 82728

Five similar codes to CPT 82728 and how they differ are:

• CPT 83540: Measures serum iron levels, which indicate the amount of iron bound to transferrin in the blood.
• CPT 83550: Measures iron binding capacity, which reflects the ability of transferrin to bind and transport iron in the blood.
• CPT 83030: Measures hemoglobin, a protein in red blood cells that carries oxygen and contains iron.
• CPT 83033: Measures fetal hemoglobin, a specific type of hemoglobin present during fetal development and in some cases of anemia.
• CPT 85460: Measures the percentage of fetal hemoglobin in red blood cells, which can help diagnose certain types of anemia or other blood disorders.

10. Examples

Here are 10 detailed examples of CPT code 82728 procedures:

1. A patient with a history of iron deficiency anemia presents with fatigue and pallor. The clinician orders a ferritin test to assess the patient’s iron status and determine if treatment is needed.
2. A patient with chronic kidney disease is experiencing worsening anemia. The clinician orders a ferritin test to evaluate the patient’s iron status and guide treatment decisions.
3. A patient with a family history of hemochromatosis presents with joint pain and fatigue. The clinician orders a ferritin test to screen for iron overload.
4. A patient undergoing treatment for iron deficiency anemia has a follow-up ferritin test to monitor the response to iron supplementation.
5. A patient with inflammatory bowel disease presents with anemia. The clinician orders a ferritin test to differentiate between iron deficiency anemia and anemia of chronic disease.
6. A patient with liver disease is being evaluated for a liver transplant. The clinician orders a ferritin test to assess the patient’s iron status as part of the pre-transplant workup.
7. A patient with a history of multiple blood transfusions presents with signs of iron overload. The clinician orders a ferritin test to confirm the diagnosis and guide treatment decisions.
8. A patient with rheumatoid arthritis is experiencing worsening anemia. The clinician orders a ferritin test to evaluate the patient’s iron status and determine if additional treatment is needed.
9. A pregnant patient with a history of iron deficiency anemia has a ferritin test to assess her iron status and ensure appropriate prenatal care.
10. A patient with a history of gastric bypass surgery presents with anemia. The clinician orders a ferritin test to evaluate the patient’s iron status and identify any potential nutritional deficiencies.