Summary & Overview
CPT 82166: Anti–Mullerian Hormone (AMH) Chemistry Test
CPT code 82166 represents a laboratory chemistry assay for anti–mullerian hormone (AMH) measured in a blood specimen. AMH testing is clinically significant for assessing ovarian reserve and fertility in females and for evaluating testicular function in males. Nationally, AMH testing informs reproductive care planning, fertility treatment decision-making, and endocrine evaluation across outpatient and laboratory settings.
Major payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context for AMH measurement, typical sites of service, and the common billing environment for this laboratory assay. The publication summarizes available benchmarks and coverage considerations, highlights relevant policy and reimbursement updates where applicable, and outlines billing and service-line implications for laboratories and clinical practices.
This summary is intended for national audiences including laboratory managers, billing professionals, clinicians involved in reproductive health, and payer policy analysts. Data not available in the input will be noted explicitly in supporting sections.
Billing Code Overview
CPT code 82166 describes a laboratory chemistry test that measures anti–mullerian hormone (AMH) levels in a blood specimen. AMH is a hormone involved in sexual development and reproductive function. Clinicians order this test to evaluate testicular function, female menopausal status, and fertility potential, among other reproductive health assessments.
Service type: Clinical laboratory testing (chemistry assay)
Typical site of service: Clinical laboratory or hospital outpatient laboratory
Clinical & Coding Specifications
Clinical Context
A 32-year-old woman presents to a reproductive endocrinology clinic for evaluation of diminished ovarian reserve and subfertility after 12 months of unprotected intercourse without conception. The clinician orders a serum anti-Müllerian hormone (AMH) test to estimate ovarian reserve and assist in fertility counseling and treatment planning. Blood is drawn in the outpatient phlebotomy area and the specimen is sent to the clinical laboratory. The lab analyst performs the chemistry assay represented by 82166 to quantify AMH concentration. Results are reported to the ordering clinician and incorporated into the patient’s fertility workup, which may include antral follicle count by transvaginal ultrasound, baseline hormone testing, and assisted reproductive technology planning.
A parallel scenario is a 45-year-old woman undergoing evaluation of menopausal status where AMH may be measured to support assessment of ovarian function, or a male patient evaluated for testicular function in specific endocrinologic contexts. Typical site of service is outpatient clinic, outpatient laboratory, or hospital outpatient draw station. The service type is clinical laboratory testing (chemistry immunoassay) performed by medical laboratory personnel and billed as a laboratory test.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component separate from the technical laboratory component (rare for automated AMH assays). |