Pathology/Lab Coding Alert

Question: A cardiologist client requested total CK and CK isoenzymes upon the patient’s hospital admission, and again from a separate blood draw 12 hours later. How should we code this?

New York Subscriber

Answer: You need two codes to report total creatine kinase (CK) and CK isoenzymes. The codes are 82550 (Creatine kinase (CK), (CPK); total) and 82552 (... isoenzymes). Because the lab performs each test twice, you should report two units of each code.

Assuming the 12-hour difference between blood draws is within the same calendar date, you might need a modifier to ensure payment for both repeat tests. Many payers expect you to append modifier 91 (Repeat clinical diagnostic laboratory test) to the second unit of each code to indicate that you’re performing a repeat test for medical reasons.

Cardiologists may use these tests to indicate whether the patient has suffered a myocardial infarction and for other diagnostic information that informs treatment.

Watch for: If the cardiologist requests just the MB isoenzyme, you should not use 82552, but should instead report 82553 (… MB fraction only).