Summary & Overview
CPT 82735: Fluoride Measurement in Plasma, Serum, or Urine
CPT code 82735 represents a quantitative laboratory test for measuring fluoride in biological specimens such as plasma, serum, or urine. Nationally, this assay supports clinical evaluation of fluoride exposure and potential toxicity, and it can inform public health considerations where water fluoridation or environmental exposure is relevant. The code is used by hospital and outpatient clinical laboratories and by providers ordering diagnostic testing for patients with suspected overexposure or for monitoring.
Key payers commonly relevant to coverage and reimbursement decisions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage policies and reimbursement levels vary by payer and by setting of service; clinical necessity documentation typically drives coverage determinations.
Readers will learn the clinical context for ordering the test, typical sites of service, common modifiers associated with laboratory billing (listed separately), and what to expect in payer coverage discussions. The publication provides benchmarks and policy-relevant information to help clinical laboratories and billing staff understand how CPT code 82735 fits into diagnostic workflows and payer interactions. Data not available in the input for specific payor policies, rates, or related ICD-10 diagnostics are noted as unavailable.
Billing Code Overview
CPT code 82735 describes a laboratory assay to measure fluoride concentration in biological samples such as plasma, serum, or urine. The test quantifies fluoride levels to assess exposure, monitor toxicity, or support clinical evaluation related to fluoride intake.
Service type: Clinical laboratory test — quantitative measurement of fluoride
Typical site of service: Clinical laboratory, hospital laboratory, or outpatient diagnostic laboratory where blood or urine specimens are collected and analyzed.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or pediatric patient undergoing evaluation of fluoride exposure or suspected fluoride toxicity. Examples include a child with altered mental status and gastrointestinal symptoms after possible ingestion of fluoride-containing toothpaste or industrial exposure, or a community-level assessment of fluoride exposure via urine testing following remediation of water fluoridation. The clinical workflow begins with triage and history-taking documenting exposure source and timing, followed by collection of a blood (plasma/serum) or urine specimen. The sample is labeled and sent to the clinical laboratory where a trained laboratory analyst performs assay 82735 to measure fluoride concentration. Results are reported to the ordering clinician, who interprets levels in the context of symptoms, exposure history, and any concurrent laboratory studies (electrolytes, renal function). Repeat testing may be ordered to trend levels after decontamination, chelation, or removal from exposure. Typical site of service: clinical laboratory within an acute care hospital, independent reference laboratory, public health lab, or outpatient collection site.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component if applicable to a lab-based consult or pathologist input on results when split billing is necessary. |