Summary & Overview
CPT 82252: Qualitative Fecal Bilirubin Test
CPT code 82252 represents a qualitative laboratory assay for the presence of bilirubin in stool. Detection of fecal bilirubin can provide clinical information about hemoglobin breakdown and potential hepatobiliary disorders; because bilirubin is typically absent from normal feces, a positive result can prompt further diagnostic evaluation. As a laboratory procedure, this code is relevant across outpatient and hospital laboratory settings and matters nationally for coding consistency, claim adjudication, and clinical workflow for gastroenterology and hepatology evaluations.
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 the test, common sites of service, and the role of this code in laboratory service lines. The publication summarizes payer coverage considerations, typical billing modifiers listed for laboratory services, and benchmarks where available. It also outlines how CPT code 82252 fits into diagnostic pathways for suspected hepatobiliary disease and stool-based testing panels.
This material is written for a national audience and focuses on code definition, clinical relevance, and the administrative context clinicians and billing professionals use when handling claims for CPT code 82252.
Billing Code Overview
CPT code 82252 describes a laboratory test for the qualitative presence of bilirubin in a feces specimen. The test determines whether bilirubin, a breakdown product of hemoglobin that is not normally present in stool, can be detected using qualitative methods such as a dipstick or tablet assay adapted from urine testing.
Service type: Clinical laboratory test — qualitative fecal bilirubin assay
Typical site of service: Clinical laboratory or hospital laboratory
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Clinical & Coding Specifications
Clinical Context
A 45-year-old outpatient presents to the gastroenterology clinic with persistent pale stools, intermittent right upper quadrant pain, and mild jaundice. The clinician orders stool testing to evaluate for abnormal bilirubin excretion as part of an evaluation for obstructive jaundice, hemolysis, or hepatobiliary disease. A nursing or laboratory assistant collects a fresh fecal specimen and sends it to the clinical laboratory. A medical laboratory scientist performs a qualitative fecal bilirubin test using a tablet or dipstick reagent designed for bilirubin detection. Results are documented in the laboratory information system and provided to the ordering gastroenterologist for correlation with liver function tests, abdominal imaging (ultrasound or CT), and clinical findings. Typical site of service includes outpatient laboratory, hospital clinical laboratory, or ambulatory surgical center when performed as part of preoperative workup. The patient scenario commonly involves referral from primary care or gastroenterology and is used to help distinguish conjugated hyperbilirubinemia with biliary obstruction from other causes of pale stools and malabsorption.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Office or other outpatient visit for the evaluation and management service | Use when the primary encounter is an outpatient visit and this lab service is ordered and billed with the visit documentation. |