Summary & Overview
CPT 83775: Malate Dehydrogenase Enzyme Assay, Blood
CPT code 83775 denotes the laboratory assay for malate dehydrogenase (MDH), an enzyme involved in the citric acid cycle. This biochemical assay, typically performed on blood specimens, is used in clinical chemistry to evaluate metabolic and tissue-specific conditions where MDH activity is clinically relevant. Nationally, accurate coding of enzymatic assays like 83775 matters for laboratory reporting, claims adjudication, and clinical case-mix documentation.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for MDH measurement, common sites of service, applicable billing modifiers and their typical use cases, and where available, payer coverage patterns and coding considerations. The publication summarizes service definitions, practical coding points, and related procedural context to assist billing and compliance teams in ensuring correct claim submission.
This summary provides benchmarks and operational context that help laboratory administrators, billing professionals, and policy analysts understand how 83775 is used in practice, what clinical scenarios prompt the test, and which payers are most relevant for reimbursement and prior authorization processes. Data not available in the input is clearly identified where applicable.
Billing Code Overview
CPT code 83775 describes a laboratory measurement of malate dehydrogenase (MDH) activity, an enzyme that catalyzes the conversion of malate to oxaloacetate in the citric acid cycle of carbohydrate metabolism. The test quantifies the amount of the enzyme, typically performed on a blood specimen.
Service Type: Clinical laboratory enzymatic assay
Typical Site of Service: Clinical laboratory or hospital laboratory (blood specimen collection and analysis)
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or pediatric inpatient or outpatient referred by a primary care physician or hospitalist for laboratory evaluation of suspected tissue injury, metabolic disturbance, or monitoring of known hepatic or muscular disease. The clinician orders measurement of serum malate dehydrogenase (83775) when there is concern for cellular injury affecting energy metabolism (for example, monitoring severity of shock, ischemia, or secondary metabolic derangements), evaluation of unexplained elevated general enzyme panels, or research/clinical chemistry panels. A phlebotomist collects a blood specimen (serum or plasma) and sends it to the clinical laboratory. In the lab, a medical laboratory scientist/technician performs the enzymatic assay to quantify malate dehydrogenase activity. Results are reviewed by a clinical pathologist or laboratory director, entered into the electronic medical record, and communicated to the ordering clinician for correlation with clinical findings, other laboratory values (such as lactate dehydrogenase, AST, ALT, creatine kinase), and imaging or hemodynamic data as appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the physician interpretation or professional portion of the lab service is billed separately from the technical component. |