Summary & Overview
CPT 82010: Quantitative Ketone Bodies Assay, Serum or Plasma
CPT code 82010 represents a quantitative laboratory assay for ketone bodies in serum or plasma, delivering a numeric result used in diagnosis and monitoring of metabolic states such as diabetic ketoacidosis and other metabolic disorders. As a fully technical laboratory procedure, the code documents the analytic measurement that informs clinical decision-making and inpatient/outpatient care.
Key payers covered in this national overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise outline of the clinical context for quantitative ketone testing, typical sites of service, and the common modifier landscape that accompanies laboratory billing for this service. The publication also summarizes typical payer coverage patterns and coding considerations relevant to laboratories and clinical providers.
This piece provides operationally relevant benchmarks and policy context: how the code is used in practice, where it commonly appears on service lines, and what clinical situations typically generate orders for quantitative ketone measurement. Data not available in the input will be identified as such in relevant sections.
Billing Code Overview
CPT code 82010 describes a quantitative ketone bodies assay performed by a laboratory analyst on serum or plasma. The service produces a numeric measurement of ketone bodies rather than a qualitative positive/negative result.
Service type: Clinical laboratory/diagnostic test (technical component)
Typical site of service: Clinical laboratory, hospital laboratory, or outpatient phlebotomy/diagnostic facility
Clinical & Coding Specifications
Clinical Context
A patient with suspected diabetic ketoacidosis (DKA) or symptomatic ketosis presents to an emergency department, urgent care clinic, or hospital inpatient unit. The clinician orders a quantitative serum or plasma ketone analysis to determine the ketone body concentration for diagnosis, severity assessment, and monitoring of response to therapy. A phlebotomist collects a serum or plasma sample; the sample is transported to the clinical laboratory where a medical technologist or lab analyst performs 82010 to generate a numeric ketone value. Results are reviewed by the ordering clinician and integrated with bedside glucose, arterial blood gas, electrolytes, and clinical exam to guide fluid resuscitation, insulin therapy, and electrolyte replacement. Typical sites of service include hospital outpatient laboratory, emergency department, inpatient hospital laboratory, and ambulatory clinics with access to a certified reference laboratory.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the provider's interpretation/report of a laboratory test that has separable technical and professional components (rare for automated quantitative ketone assays). |
TC |