Summary & Overview
CPT 83586: Urine 17-Ketosteroids, Total
CPT code 83586 represents a laboratory assay that measures total 17-ketosteroids in urine, typically from a 24-hour collection. This hormone panel primarily reflects adrenal cortex function, with testicular contribution in males. The test is used in endocrinology and internal medicine to evaluate disorders of steroid metabolism and adrenal or gonadal function. Nationally, accurate coding and claims processing for this laboratory service affect diagnostic workflow, lab billing consistency, and reimbursement for clinical chemistry testing.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical purpose of the test, typical sites of service, and common billing considerations. The publication summarizes payer coverage patterns and benchmarks where available, outlines relevant coding and documentation points for laboratory services, and places the test in clinical context for providers, billers, and policy stakeholders. Data not available in the input is clearly noted where applicable.
Billing Code Overview
CPT code 83586 measures the total amount of 17-ketosteroids in a urine specimen, most commonly collected over a 24-hour period. The test evaluates hormones primarily produced by the adrenal cortex, with additional production from the testes in males. Results help assess adrenal and gonadal steroid metabolism and can inform evaluation of endocrine disorders.
Service Type: Clinical laboratory testing — urinary steroid assay
Typical Site of Service: Clinical laboratory or outpatient collection center; specimen collected by patient or clinic over a 24-hour period
Clinical & Coding Specifications
Clinical Context
A typical patient is a 35–65-year-old adult referred for endocrine evaluation of suspected adrenal or gonadal steroid disorder. Common presenting features include unexplained hypertension, hirsutism, virilization, menstrual irregularities, or evaluation of congenital adrenal hyperplasia. The clinician orders a 24-hour urine collection for 83586 (total 17-ketosteroids) to quantify urinary steroid metabolites produced primarily by the adrenal cortex (and testes in males).
Workflow:
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The patient receives instructions for a timed 24-hour urine collection, including avoidance of interfering medications and specific dietary considerations as directed by the ordering clinician.
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The laboratory receives the labeled 24-hour specimen and logs collection time. The lab analyst performs extraction and quantitative measurement of total 17-ketosteroids using appropriate analytical methods consistent with institutional protocols.
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Results are reviewed by the ordering provider or endocrinologist and interpreted in the context of clinical presentation, serum hormone studies, and imaging when indicated. Abnormal elevations guide further workup for adrenal hyperfunction, adrenal or gonadal tumor, enzyme defects, or exogenous steroid exposure.
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Documentation in the medical record includes indication, collection instructions, specimen receipt time, analytic result, and clinical interpretation correlated with concurrent diagnoses and management planning.
Coding Specifications
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