Summary & Overview
CPT 82677: Estriol Measurement for Pregnancy
CPT code 82677 represents a laboratory assay for estriol, a weak estrogen with clinical relevance primarily in pregnancy. The assay quantifies estriol levels to support maternal-fetal assessment and endocrine evaluation in prenatal care. Nationally, accurate coding and billing for hormone assays like 82677 affect laboratory workflows, claim adjudication, and prenatal testing panels.
Key payers typically involved in coverage decisions and reimbursement for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Payer-specific medical policies and coverage criteria can influence when the test is authorized and how it is reimbursed.
Readers will find concise information about the clinical context of the test, typical sites of service, and the kinds of benchmarks and policy considerations that commonly surround laboratory pregnancy-related assays. The publication provides an overview of billing practice implications, payer coverage landscape, and clinical relevance to prenatal care. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 82677 measures the level of estriol, a weak estrogen hormone most commonly present in high concentrations during pregnancy. The test is performed by a laboratory analyst and is used to assess maternal-fetal health and endocrine status in pregnant patients.
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Service type: Clinical laboratory testing of pregnancy-related hormone levels
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Typical site of service: Clinical laboratory or hospital laboratory; specimen collection may occur in outpatient clinics or obstetrics offices
Clinical & Coding Specifications
Clinical Context
A 28-year-old pregnant patient at 18 weeks' gestation presents for prenatal laboratory evaluation after routine prenatal screening indicates a need to assess fetal well-being and maternal hormone status. The clinician orders an estriol serum assay to measure unconjugated estriol concentration to support assessment of fetal health as part of second-trimester screening for neural tube defects and chromosomal abnormalities or when evaluating suspected placental insufficiency. A phlebotomy technician collects a blood specimen in the laboratory, which is processed by a clinical laboratory scientist. The laboratory performs quantitative measurement of estriol using immunoassay or mass spectrometry methods, generates a report with the numeric value and reference range for gestational age, and transmits results to the ordering obstetric provider for interpretation and incorporation into prenatal risk assessment and counseling.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the professional interpretation portion of the laboratory test is billed separately from the technical component (rare for standalone lab tests). |
52 | Reduced services |