Summary & Overview
CPT 82943: Plasma Glucagon Level Measurement
CPT code 82943 represents a laboratory assay that quantitatively measures plasma glucagon, a pancreatic polypeptide hormone central to glucose homeostasis. This test is used in clinical evaluation of hypoglycemia, suspected glucagon-secreting tumors, and complex metabolic or endocrine disorders. Nationally, accurate coding and coverage of hormone assays affect diagnostic pathways, laboratory workflows, and payer reimbursement practices for specialized endocrine testing.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coverage and billing considerations across major commercial carriers and the Medicare program, typical sites of service and clinical contexts for ordering the test, and common modifiers that appear on lab service lines. The publication summarizes where clinicians and laboratories commonly report the service, expected service setting, and how the test is described in claims data.
The content provides clinical context for the assay, discusses operational implications for laboratory and hospital billing teams, and highlights areas where policy updates or payer-specific rules commonly affect claim adjudication. Data not available in the input is noted where relevant and omitted from clinical coding details.
Billing Code Overview
CPT code 82943 describes a laboratory measurement of glucagon level in plasma, a polypeptide hormone secreted by pancreatic islet cells. The service captures quantitative analysis of circulating glucagon to aid clinical evaluation of glucose regulation, hypoglycemia, suspected glucagonoma, or other endocrine disorders.
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Service type: Clinical laboratory test — endocrine hormone assay
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Typical site of service: Clinical laboratory or hospital laboratory; specimen collection may occur in an outpatient clinic or inpatient setting
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45-year-old adult with recurrent unexplained hypoglycemia and a history of suspected insulinoma or other pancreatic islet cell disorder. The patient presents to an endocrinology clinic after episodes of diaphoresis, tremor, confusion, and documented low capillary glucose values. The endocrinologist orders a fasting supervised laboratory evaluation including plasma glucagon measurement to evaluate counterregulatory hormone response and to help differentiate insulin-mediated hypoglycemia from other causes.
In the clinical workflow, a phlebotomy technician draws a blood sample into the appropriate tube (commonly EDTA or aprotinin-containing tube per laboratory policy), immediately places the specimen on ice, and transports it to the clinical laboratory. The laboratory analyst performs the 82943 assay using immunoassay or mass spectrometry methods to quantify plasma glucagon. Results are reviewed by the endocrinologist and incorporated into the diagnostic assessment and management plan, which may include imaging for insulinoma, medication adjustments, or referral to surgery if a tumor is suspected.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation component if the laboratory provides a separate technical component. |