Summary & Overview
CPT 80436: Metyrapone Stimulation Test for Cortisol and 11-Deoxycortisol
CPT code 80436 identifies a paired-sample endocrine laboratory test measuring cortisol and 11-deoxycortisol before and after metyrapone administration to assess adrenal function. This dynamic stimulation test is used in the diagnostic evaluation of suspected adrenal insufficiency, secondary adrenal disorders, and disorders of steroidogenesis. Nationally, accurate coding for this specialized assay supports appropriate clinical interpretation, lab reimbursement, and epidemiologic tracking of endocrine testing.
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 purpose of the test, typical sites of service, and common billing considerations. The publication presents benchmark information on utilization and payer coverage patterns where available, summarizes relevant billing and coding context, and outlines clinical indications that drive use of the test. Data not available in the input is noted explicitly where applicable.
This summary is intended for clinicians, laboratory managers, and billing professionals seeking a national perspective on coding and clinical context for CPT code 80436 and for organizations aligning laboratory workflows and claims processes for metyrapone stimulation testing.
Billing Code Overview
CPT code 80436 describes a laboratory procedure in which a lab analyst measures cortisol and 11-deoxycortisol levels in two blood samples: one drawn before and one drawn after administration of the drug metyrapone. This test evaluates adrenal function and the hypothalamic-pituitary-adrenal axis by comparing pre- and post-metyrapone steroid levels.
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Service type: Dynamic endocrine laboratory testing involving paired blood draws surrounding pharmacologic stimulation.
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Typical site of service: Hospital outpatient laboratory, clinical laboratory, or specialized endocrine testing center.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred to endocrine clinic for evaluation of suspected adrenal insufficiency vs. congenital adrenal hyperplasia or for biochemical assessment of hypothalamic–pituitary–adrenal (HPA) axis integrity. The patient presents with fatigue, weight loss, hypotension, hyponatremia, or hirsutism or has an abnormal screening cortisol. The clinical workflow: the endocrinologist orders a metyrapone stimulation test; baseline blood is drawn for serum cortisol and 11-deoxycortisol. The patient receives oral metyrapone under monitored conditions; a second blood sample is obtained at the specified post-dose interval. The laboratory measures cortisol and 11-deoxycortisol in both samples and reports levels to the ordering clinician for interpretation. Typical site of service is outpatient hospital laboratory or ambulatory infusion/observation area where oral administration and timed phlebotomy can be performed; inpatient wards or endocrine specialty clinics also perform the test when inpatient evaluation is required.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no special circumstances apply |
11 | Physician or practitioner service |