Summary & Overview
CPT 82135: Delta-Aminolevulinic Acid Test for Porphyria
CPT code 82135 represents a diagnostic laboratory assay that measures delta-aminolevulinic acid to evaluate porphyrias, inherited disorders of heme synthesis. Nationwide, this test plays a key role in confirming suspected porphyria during acute presentations and guiding further genetic and clinical evaluation. The code is relevant to specialty laboratories, hospital labs, and clinicians managing patients with neurological, abdominal, or cutaneous symptoms suggestive of porphyria.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for use of the test, typical sites of service, and the common modifier landscape. The publication provides benchmarks and coding guidance where available, summarizes insurer coverage considerations, and highlights policy updates that affect lab billing and documentation requirements.
This summary is intended for national audiences including billing professionals, clinical laboratory managers, and clinicians involved in diagnosing metabolic and hematologic disorders. It clarifies the clinical purpose of the assay and what to expect in payer interactions and coding practice. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 82135 describes a laboratory assay for delta-aminolevulinic acid used in the evaluation and diagnosis of porphyrias, a group of genetic disorders affecting heme synthesis. The test measures delta-aminolevulinic acid levels to identify abnormalities in heme production that can indicate acute or cutaneous forms of porphyria.
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Service type: Diagnostic laboratory test
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Typical site of service: Clinical laboratory or hospital laboratory setting
Clinical & Coding Specifications
Clinical Context
A 28-year-old patient presents to a hematology clinic with recurrent, unexplained abdominal pain, neuropathic symptoms (paresthesia and weakness), and episodic darkening of the urine. The clinician suspects an acute hepatic porphyria or other porphyrin disorder and orders laboratory testing including a delta-aminolevulinic acid (ALA) quantitative assay. A blood or urine specimen is collected in accordance with laboratory guidelines and transported to a clinical chemistry laboratory. The laboratory analyst performs CPT 82135 (delta-aminolevulinic acid test) to measure ALA levels, which assists in diagnosing acute porphyrias or monitoring biochemical activity. Results are reported to the ordering provider, who integrates the values with clinical findings, medication review, and family history to confirm a diagnosis, guide urgent management for acute attacks, and plan genetic counseling or further diagnostic testing as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Default; used when no other modifier applies |
11 | Normal or typical service | When the service is performed as routine and without unusual effort
22 | Increased procedural services | Rarely used for lab tests; when extraordinary technical effort is required for test performance or interpretation