Pathology/Lab Coding Alert

Question: A physician orders an IFE test for a patient with protein in the urine. What CPT® and ICD-9 codes should we report if the test demonstrates lambda free light chain monoclonal protein?

Ohio Subscriber

Answer: You should report the test as 86335 (Immunofixation electrophoresis; other fluids with concentration [e.g., urine, CSF]). 

Because this is a clinical lab test, you should list the ICD-9 code based on the diagnosis assigned by the referring physician: 791.0 (Proteinuria).

If you’re billing for a pathologist interpretation of the test (86335-26, Professional component), you could select an ICD-9 code based on the pathologist’s findings rather than the ordering diagnosis.