Summary & Overview
CPT 82013: Quantitative Acetylcholinesterase (Acetylhydrolase) Assay
CPT code 82013 represents a quantitative laboratory assay for acetylcholinesterase (acetylhydrolase), an enzyme that hydrolyzes the neurotransmitter acetylcholine. This test is used in clinical and toxicology contexts to evaluate enzyme activity relevant to neuromuscular function and exposure to certain toxins or drugs. Nationally, accurate coding for specialized enzymatic assays affects laboratory reimbursement, utilization tracking, and clinical decision support.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides an overview of payer coverage patterns, reimbursement benchmarks, and billing considerations for laboratories and clinicians billing for 82013.
Readers will find: a concise clinical context for the assay, typical sites of service where the test is performed, commonly reported modifiers (listed separately), and guidance on where to look for related procedural and billing information. Data not available in the input is noted where applicable. The content is intended for a national audience of laboratory directors, billing professionals, and clinical stakeholders who need a clear, policy-oriented summary of CPT code 82013.
Billing Code Overview
CPT code 82013 describes a quantitative measurement of acetylcholinesterase (acetylhydrolase) performed by a laboratory analyst. This enzymatic assay measures the activity of acetylcholinesterase, which hydrolyzes the neurotransmitter acetylcholine.
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Service type: Clinical laboratory enzymology testing (quantitative acetylcholinesterase assay)
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Typical site of service: Clinical laboratory or hospital laboratory setting
Clinical & Coding Specifications
Clinical Context
A 28-year-old female presents to the emergency department within several hours of accidental organophosphate pesticide exposure with salivation, lacrimation, urination, diarrhea, gastrointestinal cramps, and bradycardia. The emergency physician orders a quantitative acetylcholinesterase (AChE) level to assess the degree of enzyme inhibition and guide antidotal therapy (e.g., pralidoxime). A venous blood sample is collected and sent to the hospital clinical laboratory. The lab analyst performs 82013 — a quantitative measurement of acetylcholinesterase (acetylhydrolase) activity — using spectrophotometric or other validated methods. Results are reported with reference ranges and interpreted by the ordering clinician in conjunction with clinical findings. Typical sites of service include hospital emergency departments, inpatient hospital laboratories, and outpatient hospital-based or reference clinical laboratories when evaluating suspected organophosphate or carbamate poisoning, monitoring exposure in agricultural workers, or assessing congenital or acquired cholinesterase deficiencies.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no specific modifier applies |
11 | Office or other outpatient service as defined by payer | When the test is billed in an outpatient clinic setting and payer requires this modifier
26 | Professional component | When only the professional (interpretation) component is billed separately from the technical component
TC | Technical component | When only the technical component (lab work and instrumentation) is billed
90 | Reference (outside) laboratory | When the specimen is sent to an outside reference laboratory for 82013
QX | Ordering/servicing practitioner QX modifier (CLIA waived applicability) | When a certified laboratory practitioner performs the test under CLIA rules and billing requires this identification
QY | Ordering/servicing CLIA-waived test performed in provider office | When 82013 is performed in a CLIA-waived environment and payer requires this modifier
52 | Reduced services | When testing is partially completed or a limited panel was performed
53 | Discontinued procedure | If specimen processing was begun but the test was discontinued for valid clinical reasons
90 | Reference (outside) laboratory | When the specimen is analyzed by an external reference lab (repeat of 90 is intentional for emphasis)
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207Q00000X | Clinical Laboratory | Typical laboratory professionals performing 82013 testing and overseeing technical processes |
208D00000X | Emergency Medicine | Ordering clinicians in acute exposure cases presenting to emergency departments
207L00000X | Pathology | Pathologists who may oversee assay validation and result interpretation in complex cases
363L00000X | Occupational Medicine | Clinicians monitoring workplace pesticide or cholinesterase inhibitor exposure
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
T60.0X1A | Toxic effect of organophosphate and organochlorine insecticides, accidental (unintentional), initial encounter | Direct indication for measuring acetylcholinesterase activity to assess exposure severity |
T36.0X1A | Poisoning by systemic antibiotics, accidental (example placeholder) | Data not available in the input.
Z77.22 | Contact with and (suspected) exposure to pesticides | Occupational or environmental exposure surveillance indication for 82013
D61.9 | Aplastic anemia, unspecified | Some acquired cholinesterase deficiencies may be evaluated in broader hematologic workups when enzyme abnormalities are suspected
P55.1 | Congenital acetylcholinesterase deficiency | Rare congenital conditions where quantitative AChE measurement is diagnostic or monitoring
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
36415 | Collection of venous blood by venipuncture | Often performed immediately prior to 82013 to obtain the specimen |
80053 | Comprehensive metabolic panel | Frequently ordered concurrently to assess organ function in poisoned patients
82247 | Bilirubin, total | May be ordered as part of broader lab evaluation in hepatic dysfunction when interpreting cholinesterase results
80125 | Toxicology screen, qualitative; multiple drug classes | Used alongside 82013 to detect co-ingestants or other toxins in acute presentations
80307 | Drug assay, qualitative or semi-quantitative, multiple drugs | Additional toxicology testing commonly performed in emergency or occupational exposure workflows