Pathology/Lab Coding Alert

Question: I’ve found conflicting answers about how to bill for a Glucose 2 hour test. Patient had a fasting glucose done first and then a post glucose done at 2 hours. Would there be two lab codes for the fasting and post, or is there one that would cover them both? Does it make a difference if the physician orders the test as a GTT Post Prandial Blood Sugar, but wants only two specimens?

South Carolina Subscriber

Answer: CPT^® code 82950 (Glucose; post glucose dose [includes glucose]) represents a one-specimen glucose tolerance test, whether done at one hour or two hours after ingesting the glucose.

The test described by code 82950 does not include the fasting glucose test that you mentioned the patient received first. You should separately bill the fasting glucose as 82947 (Glucose; quantitative, blood [except reagent strip]).

The code for the three-specimen glucose tolerance test that you mentioned does include the fasting glucose, followed by two more blood samplings to test the glucose levels after giving the glucose to drink (82951, Glucose; tolerance test [GTT], 3 specimens [includes glucose]). Don’t use this code if the lab doesn’t test three specimens pulled at three different times.

Includes glucose: Don’t let the phrase “includes glucose” confuse you. This doesn’t mean that the code includes a glucose test, it means that the code includes the glucose dose given to the patient to consume.