CPT 82390: Ceruloplasmin Quantitative Serum Assay

CPT code 82390 represents a quantitative serum assay for ceruloplasmin, a key glycoprotein involved in copper metabolism. The test is clinically significant because markedly low ceruloplasmin levels strongly suggest Wilson disease, while elevated levels can accompany certain malignancies. As a routine clinical chemistry assay, this code supports diagnostic evaluation for hepatic and neurologic presentations and contributes to cancer workups when indicated.

Key national payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for ordering 82390, typical sites of service where the assay is performed, and the common modifiers and payer considerations associated with laboratory billing. The publication also outlines expected use cases, how the test factors into differential diagnosis between Wilson disease and other causes of abnormal copper metabolism, and where to look for related policy updates.

This summary provides a concise reference for clinicians, laboratory managers, and billing professionals seeking clarity on the clinical purpose of CPT code 82390, payer coverage landscape, and operational context for lab-based quantitative protein testing.

Billing Code Overview

CPT code 82390 measures the serum level of ceruloplasmin, a blue–colored glycoprotein involved in copper transport. This laboratory test is used clinically to detect low ceruloplasmin levels, which are a strong indicator of Wilson disease, and to note elevations that can occur with various malignant tumors.

Service type: Clinical laboratory test — quantitative protein assay
Typical site of service: Hospital or independent clinical laboratory, including outpatient laboratory collection sites

Data not available in the input.

Clinical Context

A 16-year-old patient with progressive neurologic symptoms (tremor, dysarthria) and elevated liver enzymes is evaluated for suspected Wilson disease. The clinician orders serum ceruloplasmin measurement to assess copper transport protein levels. Blood is collected in the outpatient laboratory; the specimen is transported to the clinical chemistry laboratory where the lab analyst performs quantitative measurement of ceruloplasmin using immunoassay methods. Results are reviewed by the ordering physician and integrated with serum copper, 24-hour urinary copper, and genetic testing for diagnostic confirmation. Typical site of service: outpatient laboratory, hospital clinical lab, or specialty reference laboratory. Typical service type: quantitative serum protein assay for diagnostic evaluation and monitoring of hepatic and neurologic disorders, and as part of oncology workup when ceruloplasmin may be elevated.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the professional interpretation component if applicable (rare for automated chemistry assays).
`TC`	Technical component	Use when billing only the technical component of the laboratory test (most common for reference labs performing the assay).

Taxonomy Code	Specialty	Notes
207RH0000X	Clinical Pathology	Laboratory physicians and directors overseeing biochemical assays.
208D00000X	Medical Laboratory Scientist	Professionals performing and validating the immunoassay.
207L00000X	Hematology/Oncology	Oncologists may order ceruloplasmin as part of tumor evaluation when indicated.
2080P0207X	Pediatrician	Pediatricians evaluate children and adolescents for Wilson disease and order ceruloplasmin testing.
207K00000X	Gastroenterology	Gastroenterologists order ceruloplasmin when evaluating unexplained liver disease.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E83.01`	Hereditary hemochromatosis	Iron-overload disorders are part of differential diagnosis for abnormal liver tests; ceruloplasmin may be measured in broader metabolic evaluation.
`E83.09`	Other disorders of copper metabolism	Directly relevant when evaluating disorders of copper handling; ceruloplasmin measurement is diagnostic.
`E83.00`	Disorders of copper metabolism, unspecified	Used when copper metabolism disorder suspected; ceruloplasmin helps differentiate causes.
`K70.9`	Alcoholic liver disease, unspecified	Liver dysfunction prompting evaluation may include ceruloplasmin among other tests.
`K74.60`	Unspecified cirrhosis of liver	Cirrhosis of unknown cause prompts testing for Wilson disease including ceruloplasmin.
`G24.5`	Wilson disease	Directly indicated; low ceruloplasmin is a strong indicator of Wilson disease.
`C80.1`	Malignant neoplasm, primary sites unspecified; metastatic disease	Ceruloplasmin can be elevated in certain malignancies and may be included in oncologic workups.
`R79.89`	Other specified abnormal findings of blood chemistry	Abnormal chemistry findings prompting targeted assays such as ceruloplasmin.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`82040`	Measurement of copper, serum	Often ordered alongside ceruloplasmin to evaluate copper metabolism and support Wilson disease diagnosis.
`82350`	Iron, total (iron-binding capacity is separate)	Ordered with ceruloplasmin in broader metabolic panels assessing hepatic function or anemia workup.
`84153`	Ammonia; plasma, quantitative	Ordered in liver disease workups where ceruloplasmin is measured to assess hepatic dysfunction.
`82542`	Protein; total, quantitative	May be ordered concurrently to assess overall serum protein levels and support interpretation of ceruloplasmin concentration.
`83020`	Hemoglobin; other hemoglobin studies	May be part of initial labs in patients with suspected systemic disease affecting hematologic parameters.

OpenPayer

Summary & Overview