Pathology/Lab Coding Alert

Question: An endocrinologist client sometimes orders total calcium and ionized calcium together for the diagnosis of hyperparathyroidism. Can we code for both tests?

Texas Subscriber

Answer: Yes, you can bill together 82310 (Calcium; total) and 82330 (... ionized) if your lab performs both tests. There are no Correct Coding Initiative (CCI) edits that restrict billing these two codes together.

Caution: The physician will need to demonstrate medical necessity for ordering both tests.

Although elevated total calcium is a common indicator of possible hyperparathyroidism, some studies point to ionized calcium as a more discriminating indicator, especially for borderline hyperparathyroidism.

Parathyroid hormone, produced by the parathyroid glands, controls calcium, phosphorus and vitamin D levels in the blood. Primary hyperparathyroidism occurs when an enlarged parathyroid gland leads to too much hormone, which raises the level of calcium in the blood.