Pathology/Lab Coding Alert
Query 2 Bilirubin Tests
Question: The lab performs a total bilirubin and direct bilirubin test. Can we report both tests, or is the direct bilirubin a calculated value? Oregon Subscriber Answer: You may report both 82247 (Bilirubin; total) and 82248 (… direct) if the lab performs both total and direct bilirubin tests. Total bilirubin measures all bilirubin present in the specimen without distinction. It is a single analysis that does not distinguish the levels of different bilirubin components. Definitions: The liver attaches (conjugates) bilirubin to glucuronic acid; the bilirubin fraction in the blood that is conjugated to the glucuronic acid is called direct bilirubin. The remaining bilirubin fraction is called unconjugated bilirubin. The direct bilirubin test measures just the conjugated fraction of bilirubin present in the specimen. It is not a calculated value. The two different bilirubin measures may have diagnostic significance when taken together. The National Correct Coding Initiative (NCCI) edits do not bundle 82247 and 82248. You may report both codes when the lab performs both tests.
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