Summary & Overview
CPT 82108: Quantitative Aluminum Assay (Serum or Urine)
CPT code 82108 denotes a quantitative laboratory assay for aluminum, most often performed on serum or urine to monitor for toxic exposure. The measure is clinically important for patients on hemodialysis and for those receiving aluminum-containing medications or with suspected environmental or occupational exposure. Nationally, this test supports patient safety by detecting potentially neurotoxic or systemic accumulation of aluminum and guiding clinical monitoring.
Key payers included in typical coverage analyses are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers can expect an overview of clinical context and indications, typical sites of service and billing considerations, and a summary of payer coverage patterns where available. The publication highlights common clinical scenarios prompting the test (dialysis monitoring, medication-related risk, and toxicity screening) and outlines the operational setting for specimen collection and laboratory processing.
Data not available in the input for payer-specific reimbursement rates, associated taxonomies, and lists of ICD-10 diagnoses. The piece focuses on the clinical role and billing identity of CPT code 82108, practical site-of-service context, and the scope of payers addressed in national coverage discussions.
Billing Code Overview
CPT code 82108 describes a laboratory quantitative measurement of aluminum in a clinical specimen. The test measures the concentration of aluminum, most commonly performed on serum or urine, to monitor for elevated levels that may indicate toxicity.
Service Type: Clinical laboratory test — quantitative element assay
Typical Site of Service: Clinical laboratory, hospital laboratory, or outpatient phlebotomy/collection site
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with end-stage renal disease receiving hemodialysis presents for routine laboratory monitoring. The nephrologist orders a quantitative serum aluminum measurement because the patient has a history of long-term dialysis and intermittent exposure to aluminum-containing phosphate binders. The clinical workflow: the provider places an order for 82108 in the electronic medical record and specifies the specimen type (serum or urine). A trained phlebotomist draws the sample under standard collection procedures and labels it with patient identifiers and collection time. The specimen is transported to the hospital or reference laboratory. A licensed clinical laboratory scientist or lab analyst performs the quantitative aluminum assay using validated methodology (e.g., atomic absorption spectrometry or ICP-MS). Results are reviewed by the performing laboratory, reported in the laboratory information system, and routed to the ordering nephrologist. Documented clinical relevance includes monitoring for aluminum toxicity (neurologic symptoms, bone disease, or anemia) in patients on dialysis or receiving aluminum-containing medications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the professional interpretation component, if applicable for tests requiring physician interpretation. |
TC | Technical component | When billing only the technical component performed by the laboratory. |
90 | Reference (outside) laboratory | When the specimen is sent to an outside independent laboratory for analysis. |
91 | Repeat clinical diagnostic laboratory test | Not in provided list; excluded. |
59 | Distinct procedural service | When another unrelated service is performed on the same day and needs to be reported separately. |
52 | Reduced services | When the test was partially reduced or not fully performed. |
53 | Discontinued procedure | When the test collection or processing was discontinued for documented patient-related reasons. |
62 | Two surgeons | Rare for lab tests; used if two qualified professionals share responsibility for interpretation. |
90 | Duplicate entry avoided; already listed. | |
78 | Unplanned return to the operating/procedure room | Not typically applicable to lab testing; included in full list but not commonly used. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207P00000X | Nephrology | Nephrologists commonly order serum or urine aluminum levels for dialysis patients. |
207R00000X | Pathology | Pathologists oversee laboratory testing and interpretation. |
163W00000X | Clinical Laboratory Science | Clinical laboratorians and laboratory directors perform and validate the assay. |
208D00000X | Internal Medicine | Internists managing chronic kidney disease patients may order this test. |
207K00000X | Endocrinology | Endocrinologists may order aluminum levels when evaluating metabolic bone disease. |
When selecting modifiers for billing 82108, the most clinically relevant are those addressing professional/technical components, reference lab processing, and service reductions or distinctness. Use payor rules and documentation to support modifier application.
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
N18.6 | End-stage renal disease | ESRD patients on dialysis are at risk for aluminum accumulation and require monitoring with 82108. |
M83.9 | Disorder of bone density and structure, unspecified | Aluminum-related osteomalacia or bone disease assessment may prompt aluminum testing. |
E87.1 | Hypo-osmolality and hyponatremia | Metabolic disturbances in renal patients may accompany or prompt evaluation for toxic exposures. |
T45.1X5A | Adverse effect of antacids and anti-gastric medications containing aluminum, initial encounter | Direct link to aluminum exposure from medications leading to monitoring of aluminum levels. |
R41.0 | Disorientation, unspecified | Neurologic symptoms potentially related to aluminum neurotoxicity that warrant measurement of aluminum levels. |
These diagnoses represent common clinical indications for ordering quantitative aluminum measurements with CPT code 82108.
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
80053 | Comprehensive metabolic panel | Common baseline panel for patients with kidney disease; often ordered alongside 82108 to evaluate renal function and electrolytes. |
83520 | Vitamin and mineral quantitative assay; trace elements (e.g., copper, zinc) | Other trace element quantitations that may be ordered with aluminum for toxicity or deficiency assessment. |
84215 | Lead; blood | Heavy metal testing frequently performed in the same clinical context or laboratory workflow as aluminum testing. |
36415 | Collection of venous blood by venipuncture | The specimen collection procedure typically performed prior to 82108 testing. |
85025 | Complete blood count (CBC) with automated differential | Ordered concurrently to assess anemia or other hematologic effects related to aluminum toxicity. |
These tests are commonly performed before, during, or after 82108 to provide comprehensive evaluation of patients at risk for aluminum-related complications.