Summary & Overview
CPT 80143: Acetaminophen Quantitative Serum Assay
CPT code 80143 identifies a quantitative laboratory assay measuring acetaminophen concentration in patient specimens (commonly serum). This code is used when the laboratory performs the technical testing to determine drug levels, which is clinically important for assessing overdose risk, guiding treatment decisions such as antidote administration, and monitoring therapeutic exposure. Nationally, toxicology and therapeutic drug monitoring are routine components of emergency, inpatient, and outpatient care pathways.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for acetaminophen testing, typical sites where the service is provided, and the kinds of benchmarks and policy considerations commonly associated with laboratory drug assays. The publication outlines reimbursement and billing practice benchmarks, common modifiers, and payer coverage considerations where available, along with notes on coding relationships and clinical utility.
This summary provides clinicians, billers, and policy stakeholders with the essential facts about CPT code 80143, the role of acetaminophen level testing in patient care, and what to expect when reviewing coverage and billing guidance for quantitative toxicology assays.
Billing Code Overview
CPT code 80143 represents a laboratory test in which a lab analyst performs the technical component to quantify the level of acetaminophen in a patient specimen, such as serum. Acetaminophen is an analgesic and fever reducer available over the counter and in prescription formulations, and this test measures drug concentration to inform clinical management.
Service Type: Clinical laboratory test — quantitative drug assay
Typical Site of Service: Clinical laboratory or hospital laboratory (serum specimen collection and analysis)
Clinical & Coding Specifications
Clinical Context
A patient arrives to the emergency department after an accidental or intentional medication ingestion and reports nausea, vomiting, and abdominal discomfort. The treating clinician obtains a medication history that suggests possible recent acetaminophen (paracetamol) overdose or uncertain timing/dose. Blood is drawn for stat toxicology testing, including a quantitative acetaminophen level to guide risk assessment and eligibility for N-acetylcysteine antidote therapy. The specimen (typically serum) is routed to the clinical laboratory. A medical laboratory scientist or clinical chemist performs the analytic assay to quantify acetaminophen, documents the result in the laboratory information system, and communicates critical values to the treating clinician. Typical site of service includes hospital inpatient laboratories, hospital emergency departments (phlebotomy or stat lab), and independent clinical laboratories receiving serum specimens. The service is a technical laboratory procedure performed by the lab analyst and reported for reimbursement under the quantitative acetaminophen assay code.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the professional interpretive component (rare for this assay) provided by a pathologist or clinical chemist separate from technical lab work. |
90 |