Summary & Overview

CPT 82777: Galectin-3 Serum/Plasma Assay for Heart Failure

CPT code 82777 designates a laboratory measurement of galectin‑3 in serum or plasma, a biomarker used in the evaluation and management of patients with heart failure. Nationally, the test is relevant for clinicians monitoring heart failure progression and assessing fibrosis‑related risk; its utilization affects laboratory services, clinical workflows, and payer coverage decisions.

Key payers in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for galectin‑3 testing, typical sites of service, and which payer types commonly encounter this code. The publication summarizes coverage and billing considerations, common modifiers applicable to the service line, and implementation implications for clinical laboratories and hospitals.

This resource provides benchmarks and policy context relevant to payer coverage and claims processing, a summary of how the test fits into heart failure management, and practical coding details that affect claims submission and reimbursement workflows. Data not provided in the input (for example, specific coverage policies, utilization rates, and associated ICD‑10 codes) are identified as unavailable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 82777galectin-3laboratory testheart failurebiomarker assayclinical laboratorylab billingdiagnostic testing

Billing Code Overview

CPT code 82777 describes a laboratory assay in which a clinical laboratory analyst measures the concentration of galectin‑3 in a serum or plasma sample. This test is used in the clinical evaluation and ongoing management of patients with heart failure, providing information about fibrosis and risk stratification.

Service type: Laboratory diagnostic test (biomarker assay)

Typical site of service: Clinical laboratory or hospital laboratory; specimen collection may occur in outpatient clinics or hospital settings

Clinical & Coding Specifications

Clinical Context

A 68-year-old patient with a history of ischemic cardiomyopathy and chronic heart failure presents for outpatient heart failure management. The cardiology team orders a serum galectin-3 measurement to assist risk stratification and to guide longitudinal monitoring of myocardial fibrosis and remodeling. Blood is drawn in the clinic or laboratory and sent to the hospital clinical chemistry or immunology laboratory. The lab analyst performs an immunoassay for galectin-3 and reports a quantitative result in ng/mL. Results are routed to the ordering cardiologist and primary care physician and documented in the electronic health record to inform decisions about diuretic titration, advanced therapy referral, or enrollment in heart-failure disease management programs.

Coding Specifications

Modifier	Description	When to Use
`11`	Physician or other qualified health care professional service	Use when the ordering physician performs and interprets the test and includes it as part of a professional service.
`26`	Professional component	Use when billing only the professional component of a split laboratory service (interpretation by physician separate from technical processing).
`TC`	Technical component	Use when billing only the technical component (instrumentation, reagent, and technician processing) of the lab test.
`90`	Reference laboratory	Use when the specimen is sent to an independent reference laboratory for testing.
`91`	Repeat clinical diagnostic test — single patient on same day to obtain subsequent measurement (Note: `91` not provided in the modifier list; ensure allowed modifiers)	Data not available in the input.
`52`	Reduced services	Use when the test is partially performed or limited compared with full procedure.
`53`	Discontinued procedure	Use if the specimen collection or testing was started but discontinued for clinical reasons.
`59`	Distinct procedural service (Note: `59` not provided in the modifier list; ensure allowed modifiers)	Data not available in the input.
`90`	Duplicate entry — professional use above (already listed)	See earlier `90`.

Taxonomy Code	Specialty	Notes
`207RC0000X`	Cardiology	Cardiologists commonly order galectin-3 to aid heart failure management and risk stratification.
`207RI0013X`	Interventional Cardiology	May be involved when elevated biomarkers prompt consideration of device therapy or invasive evaluation.
`208D00000X`	Internal Medicine	Primary care physicians manage chronic heart failure and coordinate laboratory monitoring.
`283Q00000X`	Clinical Laboratory	Laboratory medicine specialists and clinical chemists perform and validate the assay.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I50.22`	Chronic systolic (congestive) heart failure	Galectin-3 assists in risk stratification and monitoring of patients with systolic heart failure.
`I50.32`	Chronic diastolic (congestive) heart failure	Useful for assessing fibrosis and remodeling in diastolic dysfunction.
`I50.9`	Heart failure, unspecified	Applied when heart failure type is not otherwise specified; galectin-3 provides adjunctive prognostic information.
`I25.10`	Atherosclerotic heart disease of native coronary artery without angina pectoris	Coexisting ischemic heart disease commonly accompanies heart failure and prompts biomarker monitoring.
`R79.89`	Other specified abnormal findings of blood chemistry	Used when abnormal biomarker findings, including elevated galectin-3, require documentation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`82777`	Galectin-3; quantitative	Primary test measuring serum/plasma galectin-3 for heart failure risk stratification and management.
`36415`	Collection of venous blood by venipuncture	Commonly performed immediately prior to `82777` to obtain the serum or plasma sample.
`80053`	Comprehensive metabolic panel	Frequently ordered alongside biomarker testing to assess renal function, electrolytes, and metabolic status in heart failure patients.
`82565`	Creatine kinase, MB fraction (CK-MB)	May be ordered in differential evaluation of cardiac injury when clinically indicated.
`80061`	Lipid panel	Often part of cardiovascular risk assessment in patients with heart failure.