Summary & Overview
CPT 82248: Direct (Conjugated) Bilirubin Measurement
CPT code 82248 represents a laboratory test that measures direct (conjugated) bilirubin in blood. This test is clinically important for evaluating liver excretory function, detecting cholestasis or biliary obstruction, and monitoring hepatic disease progression or response to therapy. As a routine chemistry assay, it is widely used across outpatient laboratories, hospital labs, and ambulatory care settings, making it a common component of liver function testing panels nationwide.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for use of CPT code 82248, typical sites of service, and the common billing modifiers associated with laboratory services. The publication outlines payer coverage patterns and benchmark considerations where available, and summarizes policy considerations that affect lab testing reimbursement and claims processing for direct bilirubin measurement.
Intended takeaways include: what CPT code 82248 denotes clinically and operationally, how the test fits into diagnostic workflows, which major payers commonly cover the service, and where to look for payer-specific coverage rules and billing guidance. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 82248 describes a laboratory measurement of direct (conjugated) bilirubin in a patient’s blood. Direct bilirubin is the water-soluble form of bilirubin produced as the body processes and clears the breakdown products of aging red blood cells; measuring its level helps assess liver function, biliary obstruction, and related disorders.
Service type: Clinical laboratory test — quantitative measurement of direct bilirubin
Typical site of service: Clinical laboratory or hospital laboratory (blood draw performed in outpatient clinic, hospital, or ambulatory collection site)
Clinical & Coding Specifications
Clinical Context
A 48-year-old patient presents to the outpatient laboratory after referral from a primary care physician for evaluation of jaundice and elevated liver enzymes. The clinician orders a hepatic panel including measurement of direct (conjugated) bilirubin to distinguish between conjugated and unconjugated hyperbilirubinemia. The patient arrives at the ambulatory phlebotomy clinic; a trained phlebotomist draws a venous blood specimen following standard precautions. The sample is transported to the hospital clinical chemistry laboratory where a medical laboratory scientist or lab analyst performs the quantitative assay for direct bilirubin (82248) using a validated automated photometric method. Results are reviewed by the laboratory and reported to the ordering provider; an elevated direct bilirubin may prompt further hepatology evaluation, imaging (ultrasound), or additional laboratory testing (e.g., liver enzymes, hepatitis serologies). Typical sites of service include outpatient laboratories, hospital clinical laboratories, and inpatient hospital settings when monitoring hospitalized patients with suspected cholestasis or hepatocellular injury.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional interpretation component if applicable (rare for automated chemistry tests). |