Summary & Overview
CPT 82017: Quantitative Acylcarnitine Analysis
CPT code 82017 represents a quantitative acylcarnitine analysis used to detect fatty acid oxidation disorders and assist in diagnosing organic acidurias. As a specialized clinical laboratory test, it supports diagnosis and management of inborn errors of metabolism with implications for pediatric and adult metabolic care. Nationally, access to accurate acylcarnitine testing influences timely diagnosis, treatment planning, and genetic counseling.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for ordering the test, typical sites of service, and practical billing considerations tied to this laboratory service. The publication also outlines common modifiers reported with laboratory services, discusses payer coverage themes, and highlights benchmarks and policy updates affecting laboratory reimbursement and prior authorization practices. Clinical interpretation basics and indications for testing are summarized to clarify appropriate utilization.
This executive summary is intended for a national audience of clinicians, laboratory managers, and billing professionals seeking concise guidance on the role and billing context of CPT code 82017.
Billing Code Overview
CPT code 82017 covers quantitative analysis of acylcarnitines, a laboratory test used to evaluate fatty acid metabolism and to aid in diagnosing organic acidurias. The assay measures concentrations of various acylcarnitine species in blood or plasma to detect metabolic disorders such as fatty acid oxidation defects and other inborn errors of metabolism.
Service Type: Clinical diagnostic laboratory testing
Typical Site of Service: Clinical laboratory or hospital laboratory, often ordered by metabolic specialists, pediatricians, or geneticists; specimen collection may occur in outpatient clinics or inpatient settings
Clinical & Coding Specifications
Clinical Context
A newborn or pediatric patient presents with poor feeding, hypotonia, lethargy, unexplained hypoglycemia, metabolic acidosis, or failure to thrive. A pediatrician or metabolic specialist orders quantitative acylcarnitine analysis to evaluate for fatty acid oxidation defects (such as medium-chain acyl-CoA dehydrogenase deficiency) or to help characterize organic acidurias. A blood specimen (dried blood spot or plasma) is collected in the outpatient clinic, emergency department, or neonatal intensive care unit and sent to a reference laboratory. The laboratory performs tandem mass spectrometry to quantify a panel of acylcarnitine species; results are reported to the ordering clinician to guide confirmatory metabolic testing, genetic testing, dietary modifications, or acute management (eg, avoidance of fasting, IV glucose). Typical sites of service include hospital laboratories, outpatient clinics, reference laboratories, and neonatal screening programs.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Modifier not used with CPT by CMS; placeholder | Data not available in the input. |
| 11 | Office or other outpatient visit; not a modifier for lab CPTs | Data not available in the input.
| 26 | Professional component | Use when billing only the professional interpretation component if applicable and reportable for the laboratory service.
| TC | Technical component | Use when billing only the technical component (laboratory processing) of the test.
| 90 | Reference (outside) laboratory | Use when the service was performed by a reference laboratory outside the billing entity.
| 91 | Repeat clinical diagnostic lab test | Use when reporting a subsequent repeat of the same quantitative acylcarnitine test on the same day for reliability or monitoring.
| 59 | Distinct procedural service | Use when this test is a separate and distinct lab service from other tests on the same date that could be bundled.
| 52 | Reduced services | Use if a component of the assay was not performed and the service was partially reduced.
| 53 | Discontinued procedure | Use if specimen collection or testing was initiated but discontinued for clinical reasons.
| 76 | Repeat procedure by same physician (not in provided list) | Data not available in the input.
| 78 | Unplanned return to the operating/procedure room by the same physician (rarely applicable) | Use only for procedural returns; generally not applicable to this lab test.
| 82 | Assistant not available (rare for lab services) | Use if an assistant was expected for a procedure component and unavailable; rarely applicable.
| 90 | Duplicate entry above to reflect common use | See prior entry for 90.
Associated Provider Taxonomies
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207Q00000X | Clinical Pathology | Clinical pathologists oversee biochemical genetic testing and laboratory QA. |
| 2080P0003X | Pediatrician | Pediatricians order testing for infants and children with metabolic concerns.
| 2082P0800X | Medical Genetics & Genomics | Medical geneticists and biochemical genetics specialists interpret results and coordinate follow-up.
| 207L00000X | Clinical Laboratory Scientist | Laboratory specialists perform and validate the assay and reporting.
| 207LP2900X | Biochemical Molecular Pathology | Specialists involved in metabolic testing methodologies and interpretation.
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
E71.3 | Disorders of mitochondrial fatty-acid oxidation and ketogenesis | Directly related to acylcarnitine profiling to detect fatty acid oxidation defects. |
| E72.0 | Disorders of branched-chain amino-acid metabolism (eg, maple syrup urine disease) | Acylcarnitine profiles can help differentiate organic acidurias and branched-chain disorders.
| E88.0 | Metabolic disorder, unspecified | Used when a metabolic disturbance is suspected pending diagnostic clarification via acylcarnitine testing.
| P78.0 | Hypoglycemia of newborn due to inborn errors of metabolism | Newborn hypoglycemia may prompt acylcarnitine testing to evaluate fatty acid oxidation defects.
| R63.3 | Feeding difficulties and mismanagement | Failure to thrive and poor feeding in infants can be an indication for metabolic evaluation including acylcarnitine analysis.
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
80053 | Comprehensive metabolic panel | Often ordered concurrently to assess metabolic status, electrolytes, liver and renal function when metabolic disease is suspected. |
| 82043 | Amino acids; qualitative and quantitative, plasma | Ordered alongside acylcarnitine analysis to evaluate for aminoacidopathies and organic acidurias.
| 81479 | Unlisted molecular pathology procedure | May be used for specialized or reflex molecular testing if specific panels for genetic confirmation are not listed.
| 81406 | Molecular pathology procedure, enzymatic/genetic testing for metabolic disease (example) | Used when follow-up genetic testing is performed to confirm a fatty acid oxidation disorder.
| 82728 | Ferritin; serum | Sometimes included in broader metabolic workups to assess general nutritional and metabolic status.