Summary & Overview
CPT 82978: Glutathione Level, Whole Blood Assay
CPT code 82978 represents a specialized laboratory assay for measuring glutathione levels, usually from a whole blood specimen. Glutathione, a key intracellular antioxidant tripeptide, is clinically relevant because reduced levels are associated with liver and kidney diseases and other conditions involving oxidative stress. Nationally, this code matters for clinicians monitoring metabolic and hepatic/renal dysfunction and for laboratories that perform targeted biochemical testing.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines coverage and billing considerations across major commercial and public payers (Aetna, BCBS, Cigna, UHC, Medicare) to provide a comparative view for providers and laboratory administrators.
Readers will learn the clinical context for ordering the assay, typical sites of service, and what to expect in terms of billing classification and common modifiers. The report also summarizes benchmarks and policy updates where available and highlights practical coding considerations for laboratories that perform specialized biochemical testing. Data not available in the input is clearly identified in relevant sections.
Billing Code Overview
CPT code 82978 describes a laboratory assay measuring glutathione level, typically performed on a whole blood specimen. Glutathione is a tripeptide and an important intracellular antioxidant; levels are often decreased in certain liver and kidney diseases, making this test relevant for evaluating oxidative stress and metabolic dysfunction.
Service Type: Laboratory test — specialized biochemical assay
Typical Site of Service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a history of chronic hepatitis and worsening liver function is referred to the outpatient laboratory by a hepatologist to assess oxidative stress. A phlebotomy is performed with a whole blood draw and the specimen is transported to the clinical chemistry laboratory. The laboratory analyst performs the quantitative measurement of glutathione level using an appropriate assay on the whole blood sample. Results are reviewed by the ordering provider to aid in evaluation of antioxidant status and to inform management of liver disease; results may also be used in monitoring renal dysfunction or for research studies in metabolic disorders. Typical sites of service include hospital outpatient laboratories, independent clinical diagnostic laboratories, and inpatient hospital laboratories. The patient encounter includes specimen collection, processing, analysis, result verification, and reporting to the ordering clinician.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation/analysis component if separate from technical component |
TC | Technical component | Use when billing only the technical component (laboratory processing/testing) |
90 | Reference (outside) laboratory | Use when specimen is sent to an outside reference lab for testing |
91 | Repeat clinical diagnostic laboratory test | Data not available in the input. |
52 | Reduced services | Use when the laboratory test is partially reduced or not fully performed |
53 | Discontinued procedure | Use when testing was started but discontinued before completion |
59 | Distinct procedural service | Data not available in the input. |
90 | Reference (outside) laboratory | Use when performed by a separate outside laboratory (duplicate of above) |
90 | Reference (outside) laboratory | Data not available in the input. |
90 | Reference (outside) laboratory | Data not available in the input. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 208000000X | Clinical Laboratory | Laboratory directors or clinical chemists who oversee assay performance |
| 207L00000X | Pathology | Pathologists who consult on test interpretation for complex cases |
| 207Q00000X | Medical Toxicology | Specialists who may order glutathione for oxidative stress/toxic exposures |
| 207RC0000X | Internal Medicine | Hospitalists and internists who order laboratory evaluation for liver/kidney disease |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
K74.60 | Unspecified cirrhosis of liver | Cirrhosis is associated with altered glutathione metabolism and reduced antioxidant capacity |
K76.9 | Liver disease, unspecified | General liver dysfunction can lead to decreased glutathione levels |
N18.9 | Chronic kidney disease, unspecified | Renal impairment affects glutathione homeostasis and clearance |
E88.89 | Other metabolic disorders | Metabolic disorders may impact glutathione synthesis and levels |
T56.9X1A | Toxic effect of unspecified substance, accidental (initial encounter) | Toxic exposures can cause oxidative stress measured by glutathione levels |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
80047 | Basic metabolic panel | Commonly ordered concurrently to assess electrolytes and renal function when evaluating glutathione |
84443 | Assay of gamma-glutamyl transferase (GGT) | Often ordered alongside glutathione to evaluate liver function and cholestasis |
82040 | Assay of urine porphyrins (qualitative or quantitative) | May be ordered in metabolic or toxic exposure workups where oxidative stress is assessed |
82565 | Creatinine, serum | Frequently ordered with glutathione testing to assess renal function and interpret results |
82977 | Gastrin measurement (or similar specialty blood assays) | Data not available in the input. |