Pathology/Lab Coding Alert

Question: When our lab performs a fasting glucose followed by a post-glucose test, can we bill both codes? I-ve been told that we can't code both tests because the post-glucose code says, -includes glucose.-


Maryland Subscriber

Answer: For a fasting glucose test, report 82947 (Glucose; quantitative, blood [except reagent strip]). The correct code for a blood glucose test after the patient consumes a glucose dose is 82950 (Glucose; post glucose dose [includes glucose]).

Although you are correct that the 82950 code definition says, -includes glucose,- that does not mean that it includes a fasting blood glucose test. The phrase means that the code includes the cost of the glucose the patient consumes before taking the blood specimen.
 
If the lab performs a fasting glucose test as a baseline before performing a post-glucose dose test, you should report both 82947 and 82950. 

Pitfall: Don't confuse this situation with coding a glucose tolerance test (GTT), which involves three specimens. The GTT protocol involves a fasting glucose followed by a glucose dose and two (or more) subsequent blood glucose samplings. The code is 82951 (Glucose; tolerance test [GTT], three specimens [includes glucose]). You should not code 82947 in addition to 82951 because the fasting glucose is included as the first of the three specimens.

That's why a National Correct Coding Initiative edit prohibits reporting 82951 and 82947 together, but allows reporting 82950 and 82947 together.

Even if the GTT involves four specimens, you should not use 82947 for the first specimen and 82951 for the three subsequent specimens. Instead, you should report 82951 plus 82952 (Glucose; tolerance test, each additional beyond three specimens) for each additional blood glucose specimen beyond three.