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MA01.006a
A
MA01.006a
CPT Codes
Reimbursement for Components of Comprehensive Laboratory Panels

Reimbursement for Components of Comprehensive Laboratory Panels


When a certain number of individual component procedure codes are reported together, the component procedure codes will be combined into the procedure code that represents the closest related comprehensive laboratory panel and reimbursement will be made for the comprehensive laboratory panel as described below:

Table 1a: Basic Metabolic Panel (Calcium, iodized)
Panel Code​Component Code
When:
82330
is reported with 4 or more of the following:
82374
82435
82565
82947
84132
84295
84520
Reimbursement will be made for:
80047


Table 1b: Basic Metabolic Panel (Calcium, iodized)
Panel CodeComponent Code
When:
80051
82330
are reported with 1 or more of the following:
82565
82947
84520
Reimbursement will be made for:
80047


Table 2a: Basic Metabolic Panel (Calcium, total)
Panel CodeComponent Code
When 5 or more of the following are reported:
82310
82374
82435
82565
82947
84132
84295
84520
Reimbursement will be made for:
80048


Table 2b: Basic Metabolic Panel (Calcium, total)
Panel CodeComponent Code
When:
80051
is reported with 1 or more of the following:
82310
82565
82947
84520
Reimbursement will be made for:
80048


Table 3: General Health Panel
Panel CodeComponent Code
When:
80053
84443
are reported with 1 or more of the following components or component combinations:
85025
85027 + 85004
85027 + 85007
85027 + 85009
Reimbursement will be made for:
80050


Table 4: Electrolyte Panel
Panel CodeComponent Code
When 2 or more of the following are reported:
82374
82435
84132
84295
Reimbursement will be made for:
80051


Table 5a: Comprehensive Metabolic Panel
Panel CodeComponent Code
When 5 or more of the following are reported:
82040
82247
82310
82374
82435
82565
82947
84075
84132
84155
84295
84450
84460
84520
Reimbursement will be made for:
80053


Table 5b: Comprehensive Metabolic Panel
Panel CodeComponent Code
When:
80048
is reported with 1 or more of the following:
82040
82247
84075
84155
84450
84460
Reimbursement will be made for:
80053


Table 5c: Comprehensive Metabolic Panel
Panel CodeComponent Code
When:
80051
is reported with 6 or more of the following:
82040
82247
82310
82565
82947
84075
84155
84450
84460
84520
Reimbursement will be made for:
80053


Table 6: Obstetric Panel
Panel CodeComponent Code
When 1 or more of the following components or component combinations are reported:
85025
85027 + 85004
85027 + 85007
85027 + 85009
Plus each of the following:
86592
86762
86850
86900
86901
87340
Reimbursement will be made for:
80055


Table 6b: Obstetric Panel (includes HIV testing)
Panel CodeComponent Code
When 1 or more of the following components or component combinations are reported:
85025
85027 + 85004
85027 + 85007
85027 + 85009
Plus each of the following:
86592
86762
86850
86900
86901
87340
87389
Reimbursement will be made for:
80081


Table 7: Lipid Panel
Panel CodeComponent Code
When all of the following are reported:
82465
83718
84478
Reimbursement will be made for:
80061


Table 8: Renal Function Panel
Panel CodeComponent Code
When 6 or more of the following are reported:
82040
82310
82374
82435
82565
82947
84100
84132
84295
84520
Reimbursement will be made for:
80069


Table 9: Acute Hepatitis Panel
Panel CodeComponent Code
When all of the following are reported:
86705
86709
86803
87340
Reimbursement will be made for:
80074


Table 10: Hepatic Function Panel
Panel CodeComponent Code
When 4 or more of the following are reported:
82040
82247
82248
84075
84155
84450
84460
Reimbursement will be made for:
80076

06/15/2020
06/15/2020
05/04/2022
Claim Payment Policy Bulletin
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