Summary & Overview

CPT 81517: Serum Multianalyte Assay with Algorithmic Analysis for Liver Fibrosis

CPT code 81517 describes a serum-based multianalyte assay with algorithmic analysis (MAAA) that measures hyaluronic acid (HA), procollagen III amino‑terminal peptide (PIIINP), and tissue inhibitor of metalloproteinase 1 (TIMP‑1) to generate a five‑year risk score for liver fibrosis and liver‑related clinical events. Nationally, this code represents an advanced diagnostic approach that integrates biomarker quantification with algorithmic interpretation to stratify patient risk and inform clinical management pathways for chronic liver disease.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code's clinical purpose and testing workflow, payer coverage considerations, common billing modifiers, and the service setting typically involved. The publication summarizes benchmark information on how the test is described and billed, highlights policy updates affecting algorithmic laboratory tests, and provides clinical context for when the assay is used.

This summary is intended to inform clinicians, laboratory directors, coding professionals, and policy analysts about the purpose and billing context of CPT code 81517, the typical sites where the service is performed, and the payer landscape relevant to national practice patterns.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 81517multianalyte assayliver fibrosislaboratoryalgorithmic analysisbiomarkersMAAAserum test

Billing Code Overview

CPT code 81517 is a multianalyte assay with algorithmic analysis (MAAA) performed on a serum specimen to evaluate three liver-disease biomarkers: hyaluronic acid (HA), procollagen III amino-terminal peptide (PIIINP), and tissue inhibitor of metalloproteinase 1 (TIMP-1). The service includes an algorithmic component that combines laboratory results and patient data to generate a risk score estimating liver fibrosis and the likelihood of liver-related clinical events within five years.

Service type: Laboratory test with multianalyte assay and algorithmic analysis (MAAA)
Typical site of service: Clinical laboratory or hospital outpatient laboratory where serum testing and algorithmic analysis are performed

Clinical & Coding Specifications

Clinical Context

A 54-year-old patient with chronic hepatitis C infection and persistently abnormal liver chemistry is referred by a hepatology clinic for noninvasive assessment of liver fibrosis risk. The clinician orders a multianalyte serum test that measures hyaluronic acid (HA), procollagen III N‑terminal peptide (PIIINP), and tissue inhibitor of metalloproteinase‑1 (TIMP‑1) and applies an algorithm to generate a five‑year risk score for advanced fibrosis and liver‑related clinical events. A phlebotomy appointment is scheduled at an outpatient laboratory; a serum specimen is collected, processed, and analyzed by immunoassay, and the laboratory’s bioinformatics pipeline combines patient demographics and the three analyte results to produce the liver fibrosis risk report. The test report is routed to the ordering hepatologist and placed in the electronic medical record to inform longitudinal care planning, including surveillance and consideration of treatment intensification.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician interpretation component separate from the laboratory technical component, if applicable in split‑billing arrangements.
`TC`	Technical component

Taxonomy Code	Specialty	Notes
207RH0000X	Pathology & Laboratory Medicine	Clinical laboratory directors and pathologists overseeing test validation and interpretation.
207KP0101X	Clinical Pathology	Laboratory professionals performing immunoassay testing and quality control.
208000000X	Gastroenterology	Ordering providers who manage patients with chronic liver disease and interpret risk reports for clinical planning.
207L00000X	Anatomic and Clinical Pathology	Laboratories involved in reporting and integrating MAAA results.
207LP2900X	Hematopathology (laboratory)	Laboratories with specialized biomarker assay capabilities may use this taxonomy.

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Commonly performed immediately prior to the assay to obtain the serum specimen used for the MAAA test.
`80053`	Comprehensive metabolic panel (CMP)	Often ordered alongside fibrosis biomarker testing to assess liver enzymes and metabolic status that contextualize fibrosis risk.
`83036`	Hemoglobin; glycosylated (A1c)	May be ordered in patients with metabolic liver disease or diabetes as part of comorbidity assessment.
`88305`	Level IV surgical pathology, gross and microscopic examination	Not directly part of the serum assay but may be performed when biopsy is indicated after noninvasive testing suggests advanced disease.
`81002`	Urinalysis, non‑automated, without microscopy	Routine ancillary testing performed during evaluation visits; not directly related to the assay but common in workflow.

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