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CPT 83630: Stool Lactoferrin Qualitative Test

CPT code 83630 denotes a qualitative stool assay for lactoferrin, an established biomarker of intestinal inflammation. The code captures the technical laboratory procedure in which a lab analyst tests a stool specimen to determine the presence or absence of lactoferrin. This test is clinically relevant for differentiating inflammatory from noninflammatory gastrointestinal conditions and can impact diagnostic pathways nationally.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the kinds of benchmarking and payer coverage topics commonly associated with this laboratory service. The publication outlines common modifiers and operational considerations when billing this test and highlights where data is available versus not provided.

The article provides practical policy and billing context rather than clinical guidance, summarizing why CPT code 83630 matters for laboratories, clinicians ordering stool inflammatory testing, and payer coverage workflows. Data not available in the input is noted where relevant.

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Billing Code Overview

CPT code 83630 describes a qualitative laboratory test for lactoferrin performed on a stool specimen to detect intestinal inflammation. The service involves a laboratory analyst conducting the technical component of the assay to determine presence or absence of lactoferrin as an inflammatory marker.

Service Type: Laboratory — Qualitative Stool Assay

Typical Site of Service: Clinical laboratory or hospital laboratory setting

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CPT 83630: Stool Lactoferrin Qualitative Test

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Billing Code Overview

Service Type: Laboratory — Qualitative Stool Assay

Typical Site of Service: Clinical laboratory or hospital laboratory setting

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult presenting to an outpatient gastroenterology clinic or urgent care with new or worsening diarrhea, abdominal pain, or suspected inflammatory bowel disease (IBD) flare. The clinician orders a stool lactoferrin qualitative assay to detect intestinal inflammation as part of an initial workup or to distinguish inflammatory from noninflammatory causes of diarrhea. A stool specimen is collected by the patient or staff, transported to the laboratory, and logged by the accessioning technologist. The laboratory analyst performs the qualitative test 83630 on the stool specimen and documents the qualitative result (positive or negative for lactoferrin). The interpreted result is transmitted to the ordering clinician and entered into the medical record to inform decisions such as need for fecal calprotectin, stool culture, Clostridioides difficile testing, endoscopic evaluation, or escalation of anti-inflammatory therapy for patients with known IBD.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When reporting only the professional interpretation if separated from the technical lab work (rare for this technical-only stool assay).
`TC`	Technical component	When billing only the technical component; commonly used by independent laboratories performing the assay.
`59`	Distinct procedural service	When a separate, distinct lab test or service is performed on the same day that is not normally reported together.
`91`	Repeat clinical diagnostic laboratory test	When the test is repeated on the same day on a subsequent specimen for clinical reasons.
`52`	Reduced services	When the test is partially reduced or not performed to full extent.
`53`	Discontinued procedure	If the test process was started but discontinued before completion.
`90`	Reference (outside) laboratory	When the specimen was sent to an outside reference laboratory and reporting follows.
`90` (alternate common use)	External lab billing indicator	Used by billing systems to indicate outside lab processing.
`QK`	Qualified non-physician	When a qualified non-physician practitioner furnishes services in applicable settings (billing nuances vary by payer).
`QX`	Order of clinical diagnostic laboratory test by certified practitioner	When tests are ordered and performed under appropriate supervision per payer policies.
`QY`	Ordering physician is the laboratory physician	When the ordering physician is also the laboratory physician meeting regulatory requirements.
`AS`	Accredited or certified laboratory test	When performed in an accredited laboratory setting per payer requirements.
`90`	Placeholding for outside lab services	Used when distinguishing lab services provided externally; check payer specificity.

Taxonomy Code	Specialty	Notes
2080S0004X	Gastroenterology	Clinicians ordering stool inflammatory markers for evaluation of diarrhea and IBD management.
207RC0000X	Pathology	Laboratory physicians overseeing clinical lab testing and interpretations.
363L00000X	Diagnostic Laboratory/Medical Laboratory	Clinical laboratory specialists and lab directors performing or supervising the assay.
207LP2900X	Clinical Pathology	Specialists responsible for laboratory processes and quality control for microbiology/chemistry assays.
207Q00000X	Internal Medicine	Primary care and internal medicine physicians who order stool lactoferrin as part of diagnostic evaluation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K52.9`	Noninfective gastroenteritis and colitis, unspecified	Stool lactoferrin helps determine presence of intestinal inflammation in noninfective colitis.
`K52.8`	Other specified noninfective gastroenteritis and colitis	Used when specific noninfective inflammatory conditions are suspected; lactoferrin can indicate active inflammation.
`A09`	Infectious gastroenteritis and colitis, unspecified	Helps distinguish inflammatory infectious causes from noninflammatory etiologies.
`K50.90`	Crohn's disease, unspecified, without complications	Lactoferrin can indicate disease activity in Crohn disease.
`K51.90`	Ulcerative colitis, unspecified, without complications	Lactoferrin assists in assessing mucosal inflammation and monitoring flares.
`R19.7`	Diarrhea, unspecified	Common presenting symptom prompting stool lactoferrin testing to evaluate for inflammatory cause.
`R10.9`	Abdominal pain, unspecified	Non-specific abdominal pain with suspected inflammatory bowel etiology may prompt this test.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`87477`	Infectious agent antigen detection by immunoassay qualitative; Clostridioides difficile GDH	Often ordered alongside stool inflammatory testing when infectious colitis is suspected to rule in/out C. difficile.
`87493`	Infectious agent antigen detection by immunoassay; Norovirus	May be part of the infectious stool panel performed when acute viral gastroenteritis is considered.
`82274`	Fecal occult blood, immunoassay	Ordered in parallel to assess for gastrointestinal bleeding when inflammation is suspected.
`82270`	Fecal occult blood test, guaiac-based	Alternative fecal blood testing sometimes performed in initial diarrhea workup.
`83986`	Calprotectin, fecal (note: not an official CPT until specific reporting)	Fecal calprotectin is a related inflammatory marker often used along with lactoferrin to assess intestinal inflammation and IBD activity.

CPT 82009: Qualitative Ketone Bodies Test

CPT-82010-QUANTITATIVE-KETONE-BODIES-ASSAY-SERUM-PLASMA

CPT 82010: Quantitative Ketone Bodies Assay, Serum or Plasma

CPT-82013-ACETYLCHOLINESTERASE-QUANTITATIVE-ASSAY

CPT 82013: Quantitative Acetylcholinesterase (Acetylhydrolase) Assay

CPT-82016-QUALITATIVE-ACYLCARNITINES-METABOLIC-SCREEN

CPT 82016: Qualitative Acylcarnitines Metabolic Screen

CPT-82017-QUANTITATIVE-ACYLCARNITINE-ANALYSIS

CPT 82017: Quantitative Acylcarnitine Analysis

CPT-82024-QUANTITATIVE-CORTICOTROPIN-ACTH-ASSAY

CPT 82024: Quantitative Corticotropin (ACTH) Assay

CPT-82030-QUANTITATIVE-CAMP-PLASMA-URINE-ASSAY

CPT 82030: Quantitative cAMP Assay on Plasma or Urine

CPT-82040-QUANTITATIVE-ALBUMIN-MEASUREMENT

CPT 82040: Quantitative Albumin Measurement in Blood

CPT-82042-QUANTITATIVE-ALBUMIN-NONBLOOD-FLUID

CPT 82042: Quantitative Albumin in Non-Blood Body Fluid

CPT-82043-URINE-ALBUMIN-QUANTITATION-KIDNEY-DISEASE

CPT 82043: Urine Albumin Quantitation for Kidney Disease

Showing 1–10 of 411

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When reporting only the professional interpretation if separated from the technical lab work (rare for this technical-only stool assay).
`TC`	Technical component	When billing only the technical component; commonly used by independent laboratories performing the assay.
`59`	Distinct procedural service	When a separate, distinct lab test or service is performed on the same day that is not normally reported together.
`91`	Repeat clinical diagnostic laboratory test	When the test is repeated on the same day on a subsequent specimen for clinical reasons.
`52`	Reduced services	When the test is partially reduced or not performed to full extent.
`53`	Discontinued procedure	If the test process was started but discontinued before completion.
`90`	Reference (outside) laboratory	When the specimen was sent to an outside reference laboratory and reporting follows.
`90` (alternate common use)	External lab billing indicator	Used by billing systems to indicate outside lab processing.
`QK`	Qualified non-physician	When a qualified non-physician practitioner furnishes services in applicable settings (billing nuances vary by payer).
`QX`	Order of clinical diagnostic laboratory test by certified practitioner	When tests are ordered and performed under appropriate supervision per payer policies.
`QY`	Ordering physician is the laboratory physician	When the ordering physician is also the laboratory physician meeting regulatory requirements.
`AS`	Accredited or certified laboratory test	When performed in an accredited laboratory setting per payer requirements.
`90`	Placeholding for outside lab services	Used when distinguishing lab services provided externally; check payer specificity.

Taxonomy Code	Specialty	Notes
2080S0004X	Gastroenterology	Clinicians ordering stool inflammatory markers for evaluation of diarrhea and IBD management.
207RC0000X	Pathology	Laboratory physicians overseeing clinical lab testing and interpretations.
363L00000X	Diagnostic Laboratory/Medical Laboratory	Clinical laboratory specialists and lab directors performing or supervising the assay.
207LP2900X	Clinical Pathology	Specialists responsible for laboratory processes and quality control for microbiology/chemistry assays.
207Q00000X	Internal Medicine	Primary care and internal medicine physicians who order stool lactoferrin as part of diagnostic evaluation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K52.9`	Noninfective gastroenteritis and colitis, unspecified	Stool lactoferrin helps determine presence of intestinal inflammation in noninfective colitis.
`K52.8`	Other specified noninfective gastroenteritis and colitis	Used when specific noninfective inflammatory conditions are suspected; lactoferrin can indicate active inflammation.
`A09`	Infectious gastroenteritis and colitis, unspecified	Helps distinguish inflammatory infectious causes from noninflammatory etiologies.
`K50.90`	Crohn's disease, unspecified, without complications	Lactoferrin can indicate disease activity in Crohn disease.
`K51.90`	Ulcerative colitis, unspecified, without complications	Lactoferrin assists in assessing mucosal inflammation and monitoring flares.
`R19.7`	Diarrhea, unspecified	Common presenting symptom prompting stool lactoferrin testing to evaluate for inflammatory cause.
`R10.9`	Abdominal pain, unspecified	Non-specific abdominal pain with suspected inflammatory bowel etiology may prompt this test.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`87477`	Infectious agent antigen detection by immunoassay qualitative; Clostridioides difficile GDH	Often ordered alongside stool inflammatory testing when infectious colitis is suspected to rule in/out C. difficile.
`87493`	Infectious agent antigen detection by immunoassay; Norovirus	May be part of the infectious stool panel performed when acute viral gastroenteritis is considered.
`82274`	Fecal occult blood, immunoassay	Ordered in parallel to assess for gastrointestinal bleeding when inflammation is suspected.
`82270`	Fecal occult blood test, guaiac-based	Alternative fecal blood testing sometimes performed in initial diarrhea workup.
`83986`	Calprotectin, fecal (note: not an official CPT until specific reporting)	Fecal calprotectin is a related inflammatory marker often used along with lactoferrin to assess intestinal inflammation and IBD activity.

CPT 82009: Qualitative Ketone Bodies Test

CPT-82010-QUANTITATIVE-KETONE-BODIES-ASSAY-SERUM-PLASMA

CPT 82010: Quantitative Ketone Bodies Assay, Serum or Plasma

CPT-82013-ACETYLCHOLINESTERASE-QUANTITATIVE-ASSAY

CPT 82013: Quantitative Acetylcholinesterase (Acetylhydrolase) Assay

CPT-82016-QUALITATIVE-ACYLCARNITINES-METABOLIC-SCREEN

CPT 82016: Qualitative Acylcarnitines Metabolic Screen

CPT-82017-QUANTITATIVE-ACYLCARNITINE-ANALYSIS

CPT 82017: Quantitative Acylcarnitine Analysis

CPT-82024-QUANTITATIVE-CORTICOTROPIN-ACTH-ASSAY

CPT 82024: Quantitative Corticotropin (ACTH) Assay

CPT-82030-QUANTITATIVE-CAMP-PLASMA-URINE-ASSAY

CPT 82030: Quantitative cAMP Assay on Plasma or Urine

CPT-82040-QUANTITATIVE-ALBUMIN-MEASUREMENT

CPT 82040: Quantitative Albumin Measurement in Blood

CPT-82042-QUANTITATIVE-ALBUMIN-NONBLOOD-FLUID

CPT 82042: Quantitative Albumin in Non-Blood Body Fluid

CPT-82043-URINE-ALBUMIN-QUANTITATION-KIDNEY-DISEASE

CPT 82043: Urine Albumin Quantitation for Kidney Disease

Showing 1–10 of 411

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 83630: Stool Lactoferrin Qualitative Test

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Billing Code Overview

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CPT 83630: Stool Lactoferrin Qualitative Test

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References