Summary & Overview
CPT 82540: Quantitative Creatine Assay in Patient Specimen
CPT code 82540 identifies a quantitative laboratory assay for creatine in a patient specimen. Measuring creatine supports clinical evaluation of muscle metabolism and certain metabolic conditions and is part of routine laboratory workflows in hospitals and commercial clinical laboratories. Nationally, laboratory biochemical assays like this are widely used for diagnostic clarification, monitoring, and research.
Key payers in the national analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what CPT code 82540 represents, typical sites of service, and the clinical context for ordering the test. The publication summarizes benchmarking and reimbursement context where available, outlines common billing considerations, and highlights any recent policy or coverage themes impacting laboratory test coding and payment. The report is intended to inform billing staff, laboratory managers, and health policy analysts about the clinical role of the creatine assay and the coding parameters relevant to its use. Data not available in the input is explicitly noted where applicable.
Billing Code Overview
CPT code 82540 measures the amount of creatine in a patient specimen. Creatine is a nitrogenous organic acid produced in the human body from amino acids and is often assessed in laboratory evaluation of muscle metabolism and certain metabolic disorders.
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Service type: Clinical laboratory quantitative assay
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Typical site of service: Clinical laboratory or hospital laboratory setting
Data not available in the input for payers, taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult being evaluated for suspected muscle wasting, myopathy, or metabolic disorders, or undergoing baseline renal function assessment where measurement of creatine in blood or urine helps clarify muscle mass or metabolic status. A patient presents to an outpatient laboratory or hospital inpatient floor with an order for creatine quantification (CPT 82540) after clinician evaluation for symptoms such as unexplained weakness, muscle pain, elevated creatine kinase, or monitoring of a neuromuscular disease.
The clinical workflow: the clinician places an order in the electronic health record specifying CPT 82540. Phlebotomy staff collect the required specimen (serum, plasma, or urine) following specimen handling instructions. The specimen is transported to the clinical chemistry lab where a lab analyst prepares and analyzes the sample using validated biochemical or instrument methods to determine creatine concentration. Results are reviewed, verified by a qualified technologist or pathologist, and released to the ordering provider. Documentation includes the test order, specimen source and time, analytical method, result with reference range, and verifier identity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |