Pathology/Lab Coding Alert

Question: What are the clinical indications for C-reactive protein test versus high-sensitivity C-reactive protein?

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Answer: Physicians often order the C-reactive protein (CRP) test (86140, C-reactive protein) when they suspect an acute infection, such as you might see in cases of appendicitis, or to help diagnose conditions that involve chronic elevated levels of inflammation, such as rheumatoid arthritis.

Although the high-sensitivity (hs-CRP) test evaluates the specimen for the presence of the same proteins, the lab method is slightly different and can detect lower levels of CRP. Clinicians may order hs-CRP (86141, … high sensitivity [hsCRP]) to help evaluate patients for risk of cardiovascular disease.

Here’s why: Long term low level inflammation may play a role in atherosclerosis, which can lead to cardiovascular disease. Some clinicians think that following the patient’s hs-CRP test results can identify chronic low levels of inflammation that increase the patient’s risk of developing heart disease.