Pathology/Lab Coding Alert

Question: How should we bill a glucose 2 hour test — we tested the patient’s fasting glucose, then a post-glucose test at two hours. Should I bill two codes for the fasting glucose and post-glucose, or is there a single code that covers both tests?

Subscriber

Answer: You should bill this as two separate tests. The first is the fasting glucose, which you should report with 82947 (Glucose; quantitative, blood (except reagent strip)). The second test is post-glucose (82950, Glucose; post glucose dose (includes glucose)), and you could use the code even if the second test isn’t exactly two hours after the glucose dose.

Coder tip: Don’t be confused by the words “includes glucose” in code 82950. That simply means that the code includes administering a dose of glucose to the patient. Some coders have misinterpreted those words to mean that the code includes the initial (fasting) glucose test.

Better choice: The problem with what you’ve described is that a single test and code describe the standard procedure for this type of testing, which is a glucose tolerance test involving an initial fasting glucose plus two post-glucose readings. Because the physician did not order that test, and the lab did not perform it, you can’t use the code 82951 (Glucose; tolerance test (GTT), 3 specimens (includes glucose)).

Bottom line: Your provider must order the desired test. Without ordering the GTT (82947), the lab must do what is ordered, which was two separate tests, in this case. You should discuss this with your providers.