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