CPT 82435: Serum Chloride Measurement

CPT code 82435 denotes the laboratory measurement of serum chloride, a basic electrolyte test used widely in acute and outpatient clinical care to evaluate fluid balance and acid–base disorders. Nationally, this test is a routine component of electrolyte panels and basic metabolic assessments, making it a high-volume diagnostic procedure with relevance for hospital laboratories, independent clinical labs, and outpatient testing sites. Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn what CPT code 82435 covers clinically and operationally, the typical sites of service where the assay is performed, and the payer landscape associated with coverage and billing practice. The publication summarizes benchmarking context, common billing considerations, and clinical context for interpreting chloride values. Data not available in the input is noted where payer-specific rates, taxonomies, ICD-10 pairings, and related codes would normally appear.

Billing Code Overview

CPT code 82435 describes a laboratory procedure measuring the serum chloride (Cl) concentration in a patient's blood. The service involves the technical laboratory test performed by a lab analyst or technologist to quantify chloride levels, which can assist clinicians in assessing electrolyte balance, acid-base status, and hydration.

Service type: Clinical laboratory analytic test
Typical site of service: Clinical laboratory or hospital laboratory setting

Clinical Context

A typical patient is an adult who presents to an outpatient clinic, emergency department, or hospital floor with symptoms such as dehydration, weakness, altered mental status, edema, or signs of an electrolyte disturbance. The clinician orders basic metabolic panel testing that includes serum chloride measurement to evaluate electrolyte balance and acid–base status. A phlebotomy technician draws a venous blood specimen, which is transported to the clinical laboratory. The laboratory technologist performs the 82435 chloride assay using an automated chemistry analyzer. Results are posted to the electronic medical record and reviewed by the ordering clinician to guide fluid management, diuretic adjustments, or further diagnostic testing such as arterial blood gas, comprehensive metabolic panel, or imaging when indicated.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the interpretive/professional portion if applicable for specialized lab interpretation separate from technical testing.
`TC`	Technical component

Taxonomy Code	Specialty	Notes
`207Q00000X`	Clinical Pathology	Laboratory directors and pathologists overseeing chemistry testing.
`207L00000X`	Clinical Laboratory	Medical laboratory scientists/technologists performing `82435`.
`207K00000X`	Clinical Chemistry	Specialists in chemistry testing and validation of assays.
`208D00000X`	Emergency Medicine	Ordering clinicians frequently request rapid electrolyte testing.
`208000000X`	Internal Medicine	Primary ordering providers for metabolic panels in inpatient/outpatient care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E87.70`	Electrolyte disorder, unspecified	General indication for measuring serum chloride when electrolyte imbalance is suspected.
`E87.6`	Hypokalemia	Often assessed with chloride because potassium and chloride perturbations coexist and guide replacement therapy.
`E87.5`	Hyperkalemia	Electrolyte panels including chloride help evaluate overall electrolyte shifts.
`E87.4`	Mixed acid-base disorder	Chloride level informs acid–base interpretation, particularly hyperchloremic metabolic acidosis.
`N17.9`	Acute kidney failure, unspecified	Kidney dysfunction commonly causes abnormal chloride and warrants serial monitoring.
`I10`	Essential (primary) hypertension	Diuretic therapy for hypertension can alter chloride and prompt monitoring.
`E86.0`	Dehydration	Volume depletion commonly leads to chloride concentration changes and requires testing.
`K74.60`	Unspecified cirrhosis of liver	Liver disease affects fluid/electrolyte balance; chloride measurement is part of routine labs.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`80053`	Comprehensive metabolic panel	Often ordered alongside `82435` as part of a panel including chloride, sodium, potassium, bicarbonate, BUN, creatinine, glucose, and liver tests.
`80051`	Electrolyte panel	Includes a group of electrolytes; chloride is commonly included and may be reported with this panel.
`82465`	Carbon dioxide (bicarbonate) assay	Frequently ordered together to assess acid–base status alongside chloride.
`80047`	Basic metabolic panel (BMP)	Standard panel that typically includes chloride; `82435` may be billed as part of or in addition to BMP depending on lab billing practices.
`80500`	Blood gas analysis (arterial)	Performed when chloride abnormalities suggest acid–base disturbance; not a direct replacement but complementary diagnostic test.
`81002`	Urinalysis, non-automated, without microscopy	May be ordered in parallel when evaluating electrolyte or volume status changes that affect urinary findings.

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Summary & Overview