Summary & Overview
CPT 83593: 17-Ketosteroids, Urine Fraction Analysis
CPT code 83593 denotes a laboratory assay measuring fractions of 17-ketosteroids in a 24-hour urine specimen to assess adrenal and gonadal steroid metabolism. This specialized endocrine test supports evaluation of adrenal cortical function and, in males, contributions from the testes. Nationally, such endocrine metabolic assays inform diagnosis and management of disorders related to adrenal hyperfunction, hypofunction, and certain metabolic conditions, and they are performed primarily in clinical and hospital outpatient laboratories.
Key payers included in the coverage discussion are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the test, the typical site of service, and which national payers are relevant for coverage discussions. The publication outlines expected benchmarks and coding practice considerations where available, summarizes common modifier usage (input provided), and highlights policy and billing elements affecting laboratory reporting and claims submission for this test.
This summary is written for a national audience and focuses on the clinical and administrative attributes of CPT code 83593, providing practitioners and billing professionals with a clear reference on what the code represents, where it is performed, and which major payers are commonly involved in coverage and reimbursement conversations.
Billing Code Overview
CPT code 83593 describes a laboratory measurement of the fractions of 17-ketosteroids (17-KS), typically performed on a 24-hour urine collection. The test quantifies hormone metabolites primarily produced by the adrenal cortex in both sexes, with additional contribution from the testes in males. This assay is a specialized endocrine laboratory service used to evaluate adrenal and gonadal steroid metabolism.
Service type: Laboratory test — endocrine/metabolic analysis
Typical site of service: Clinical laboratory or hospital outpatient laboratory setting where 24-hour urine collections are processed and analyzed.
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient presents to an endocrine clinic with progressive virilization, irregular menses, and persistent hypertension. The endocrinologist orders a 24-hour urine collection to measure urinary 17-ketosteroid fractions to assess adrenal androgen production and to help differentiate adrenal versus gonadal sources of androgen excess. The clinical workflow: the provider issues an order for 83593; the patient receives written and verbal instructions for accurate 24-hour urine collection (start after first morning void, collect all urine for 24 hours, store refrigerated); the specimen is delivered to the outpatient laboratory or hospital clinical chemistry lab; a medical technologist or laboratory analyst performs the fractionation assay and reports quantitative results to the ordering physician; results are reviewed alongside serum hormone assays, imaging (if indicated), and clinical signs to guide further endocrine evaluation or imaging of the adrenal glands or testes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the professional interpretation/report portion of the test is billed separately from the technical component. |
TC |