Summary & Overview
CPT 82247: Total Bilirubin Test
CPT code 82247 represents a laboratory assay that quantifies total bilirubin in blood, a widely used metric for evaluating liver function, hemolytic processes, and jaundice. Nationally, total bilirubin testing is a routine diagnostic tool across inpatient and outpatient settings and impacts care pathways ranging from neonatal screening to evaluation of suspected hepatic injury.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for CPT code 82247, common sites of service where the test is performed, and the typical role of the measurement in diagnostic workups. The publication also summarizes payer coverage patterns and coding considerations relevant to laboratories and billing departments. Where input data is not provided, the report notes that specific items are unavailable.
This summary equips readers with a practical understanding of what CPT code 82247 denotes, why it matters in clinical workflows, and which national payers are relevant to coverage and reimbursement discussions.
Billing Code Overview
CPT code 82247 measures the total bilirubin concentration in a patient’s blood. Bilirubin is the yellow pigment produced during the normal breakdown of red blood cells and processed by the liver; measuring total bilirubin helps assess liver function, hemolysis, and jaundice.
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Service type: Clinical laboratory test — quantitative chemistry analysis
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Typical site of service: Hospital laboratory, independent clinical laboratory, outpatient phlebotomy site, or point-of-care locations where blood chemistry testing is performed
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient presents to the outpatient laboratory after referral from their primary care clinician for evaluation of jaundice and fatigue. The clinician orders a total bilirubin test to assess hepatic excretory function and to help differentiate hemolysis, hepatocellular injury, and obstructive cholestasis. The patient arrives to the phlebotomy station; venous blood is drawn into the appropriate serum tube, labeled, and transported to the clinical chemistry laboratory. The laboratory analyst performs an automated spectrophotometric bilirubin assay, documents the result in the laboratory information system, and routes the final report to the ordering clinician. Typical sites of service include hospital outpatient laboratories, independent clinical laboratories, and ambulatory clinic phlebotomy centers. Common clinical workflows include pretest specimen collection and labeling, sample transport, analytical testing, quality control verification, result validation by a medical laboratory scientist, and electronic reporting to the clinician responsible for diagnosis and management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component if applicable to complex laboratory consultations (rare for routine chemistry panels). |
TC |