Oncology & Hematology Coding Alert

Question: The physician ordered a basic metabolic panel and hepatic function panel for a patient. Do we report 80053 since it includes the other tests?

Oregon Subscriber

Answer: No, you should code each panel individually with 80076 (Hepatic function panel ...) and either 80047 (Basic metabolic [Calcium, ionized] . . .) or 80048 (Basic metabolic panel [Calcium, total] ...). Pay special attention to the tests each panel must include before you report the code:

• Code 80047 includes ionized calcium, carbon dioxide, chloride, creatinine, glucose, potassium, sodium, and urea nitrogen (BUN)
• Code 80048 includes total calcium, carbon dioxide, chloride, creatinine, glucose, potassium, sodium, and urea nitrogen (BUN)
• Code 80076 includes albumin, total bilirubin, direct bilirubin, alkaline phosphatase, total protein, alanine amino transferase (ALT) (SGPT), and aspartate amino transferase (AST) (SGOT).

Compare those to 80053 (Comprehensive metabolic panel; this panel must include the following: Albumin [82040], Bilirubin, total [82247], Calcium, total [82310], Carbon dioxide [bicarbonate] [82374], Chloride [82435], Creatinine [82565], Glucose [82947], Phosphatase, alkaline [84075], Potassium [84132], Protein, total [84155], Sodium [84295], Transferase, alanine amino [ALT] [SGPT] [84460], Transferase, aspartate amino [AST] [SGOT] [84450], Urea nitrogen [BUN] [84520]).

Code 80053 includes many of the tests covered by 80047, 80048, and 80076, but not all. For example, 80076 includes a test for direct bilirubin, but 80053 does not. Before you can report a comprehensive lab code for several panels, you must be sure the comprehensive code includes everything covered by the other panels.