Summary & Overview
CPT 80410: Calcitonin Stimulation Panel, Three Tests
CPT code 80410 represents a calcitonin stimulation panel involving three calcitonin measurements obtained after stimulation (for example with calcium or pentagastrin). This diagnostic laboratory test aids evaluation of calcitonin secretion and is clinically relevant in the assessment of suspected medullary thyroid carcinoma and other endocrine disorders. Nationally, the code matters because it captures a specialized endocrine assay that may affect diagnostic pathways and subsequent management decisions.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and coding description, payer coverage considerations, common modifiers used with the service, and where available, benchmark and policy information relevant to laboratory coding for endocrine stimulation tests. The publication outlines typical sites of service and operational notes for labs and billing staff. Data not available in the input is identified where applicable.
This summary provides clinicians, laboratory managers, and coding professionals with the essential facts about CPT code 80410, what it denotes clinically, and the payer landscape to expect when documenting and billing a calcitonin stimulation panel.
Billing Code Overview
CPT code 80410 describes a calcitonin stimulation panel in which a laboratory analyst performs stimulation testing (for example using calcium or pentagastrin) and measures three calcitonin levels. This service is a diagnostic laboratory procedure used to evaluate calcitonin secretion, commonly in the workup for suspected medullary thyroid carcinoma or related endocrine disorders.
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Service type: Diagnostic endocrine laboratory testing (stimulation test)
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Typical site of service: Clinical laboratory or hospital laboratory setting; testing is performed where stimulated blood sampling and timed assays can be collected and processed.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred by an endocrinologist for a calcitonin stimulation panel to evaluate suspected medullary thyroid carcinoma (MTC) or to assess calcitonin secretion in the setting of a thyroid nodule or familial MEN2 syndrome. The patient presents to an outpatient phlebotomy or endocrine clinic. Baseline blood is drawn for a serum calcitonin level, then the laboratory-administered stimulation agent (commonly intravenous calcium or intramuscular pentagastrin where available) is given under monitored conditions. Serial blood samples are collected at specified intervals (commonly three post-stimulation draws) to measure stimulated calcitonin responses. Vital signs are monitored for adverse reactions to the stimulant; emergency equipment is available. The lab analyst performs three calcitonin assays from the timed specimens and reports baseline and stimulated values. Results are interpreted by the ordering clinician in the context of clinical findings, imaging, and family history to guide further diagnostic steps such as genetic testing or surgical referral. Typical sites of service are outpatient hospital laboratories, hospital outpatient departments, or freestanding clinical laboratories that can administer stimulation agents and perform timed phlebotomy and monitoring.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the physician interpretation (professional component) of the lab result is billed separately from the technical component. |