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The CPT® Code 82435 refers to the laboratory test for measuring chloride levels in a blood sample. Chloride is a crucial negatively charged electrolyte that plays a significant role in various physiological processes within the body. It works in conjunction with other electrolytes, including potassium, sodium, and carbon dioxide (CO2), to help regulate fluid balance and maintain the proper acid-base equilibrium. Chloride is present in all body fluids, with the highest concentration found in the blood. The levels of chloride typically mirror those of sodium, meaning that when sodium levels rise or fall, chloride levels tend to follow suit, except in cases of acid-base imbalances. In such instances, chloride functions as a buffer, allowing its levels to fluctuate independently of sodium. The measurement of chloride is essential for screening and monitoring electrolyte levels and acid-base balance, and it is typically performed using ion-selective electrode (ISE) methodology, which provides accurate and reliable results for clinical assessment.
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The measurement of chloride levels in the blood is indicated for various clinical scenarios, particularly when assessing electrolyte balance and acid-base status. The following conditions may warrant this test:
The procedure for measuring chloride levels in the blood involves several key steps, which are outlined below:
After the chloride measurement procedure, there are generally no specific post-procedure care requirements for the patient, as the blood draw is minimally invasive. Patients may experience slight discomfort or bruising at the puncture site, which typically resolves quickly. The healthcare provider will review the results of the chloride test in conjunction with other laboratory findings and clinical assessments to determine the appropriate course of action, if necessary. Follow-up may be required based on the results, especially if any abnormalities are detected that could indicate an electrolyte or acid-base imbalance.
| Short Descr | ASSAY OF BLOOD CHLORIDE | Medium Descr | CHLORIDE BLD | Long Descr | Chloride; blood | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | CLIA Waived (QW) | Yes | APC Status Indicator | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 233 - Laboratory - Chemistry and Hematology |
| QW | Clia waived test | 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | GA | Waiver of liability statement issued as required by payer policy, individual case | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | GW | Service not related to the hospice patient's terminal condition | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | GZ | Item or service expected to be denied as not reasonable and necessary | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q4 | Service for ordering/referring physician qualifies as a service exemption | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| Pre-1990 | Added | Code added. |
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