Summary & Overview
CPT 80074: Acute Hepatitis Serology Panel
CPT code 80074 represents an acute hepatitis serology panel that combines testing for hepatitis A IgM, hepatitis B core IgM, hepatitis B surface antigen, and hepatitis C antibody. This panel is used to evaluate suspected recent viral hepatitis and guides clinical management, infection control, and public health reporting. Nationally, accurate laboratory coding for acute hepatitis testing is important for clinical workflows, surveillance, and appropriate payer reimbursement.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find practical information on the clinical purpose of the panel, typical sites of service, and payer coverage considerations. The publication outlines common modifiers encountered in laboratory billing and highlights areas where policy updates or payer-specific rules commonly affect claims processing. The content provides context about how the panel fits within laboratory service lines and what billing professionals should know about coding this combined serology test.
The piece is aimed at billing managers, laboratory directors, and policy analysts seeking concise guidance on CPT code 80074, including benchmarking points and policy implications relevant at a national level. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 80074 describes an acute hepatitis panel performed by a laboratory analyst. The panel must include tests for hepatitis A IgM antibody, hepatitis B core IgM antibody, hepatitis B surface antigen, and hepatitis C antibody.
Service type: Laboratory testing — infectious disease serology panel.
Typical site of service: Clinical laboratory or hospital outpatient laboratory.
Clinical & Coding Specifications
Clinical Context
A 34-year-old outpatient with acute onset jaundice, right upper-quadrant pain, dark urine, and recent travel to an area with viral hepatitis exposure presents to an urgent care clinic. The clinician orders an acute hepatitis panel to evaluate for recent infection. A phlebotomy technician draws blood; the specimen is sent to the clinical laboratory. The lab analyst performs serologic testing that must include hepatitis A IgM antibody, hepatitis B core IgM antibody, hepatitis B surface antigen, and hepatitis C antibody as a bundled panel. Results are reviewed by the laboratory director and released to the ordering clinician; positive acute markers prompt immediate clinician notification for public health reporting and patient counseling. Typical sites of service include hospital outpatient laboratories, independent reference laboratories, urgent care centers, and emergency departments where acute viral hepatitis is in the differential diagnosis.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the professional interpretation or reporting component of a laboratory test is billed separately (rare for automated serology panels). |
52 | Reduced services |