Summary & Overview
CPT 84110: Urine Porphobilinogen (PBG) Test
CPT code 84110 represents a clinical laboratory assay to measure porphobilinogen (PBG) in urine, a key diagnostic test for disorders of heme synthesis such as acute porphyrias. Nationally, this test is clinically significant because prompt identification of elevated PBG can guide urgent diagnostic and management decisions for patients presenting with compatible symptoms. Typical performance occurs in clinical or hospital laboratories with outpatient specimen collection.
Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise assessment of how CPT code 84110 is classified, common service settings, and which payers typically cover the test. The publication outlines available benchmarks and coverage patterns where provided, summarizes relevant clinical context for ordering the test, and flags areas where data was not provided in the input.
This summary is intended for clinicians, laboratory managers, and billing professionals seeking a national-level overview of CPT code 84110 and its role in diagnostic testing for porphyria and related conditions.
Billing Code Overview
CPT code 84110 describes a laboratory analysis that measures porphobilinogen (PBG) levels in a urine specimen. The test is used to evaluate suspected disorders of heme synthesis, including acute porphyrias, by quantifying PBG concentration in a patient urine sample.
Service type: Clinical laboratory test (urine analyte measurement)
Typical site of service: Clinical laboratory or hospital laboratory, outpatient specimen collection site
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an outpatient clinic or emergency department with acute onset severe abdominal pain, neurologic symptoms (confusion, neuropathy), unexplained dark or reddish urine, or a history suggesting acute porphyria. The clinician collects a random or spot urine specimen and orders a porphobilinogen (PBG) quantitative urine test (84110) to evaluate for an acute porphyric attack. The specimen is sent to the hospital or reference laboratory. The laboratory analyst performs the 84110 assay, records specimen identifiers, performs analysis per assay protocol, and reports numeric PBG concentration with reference range. Results are communicated to the ordering provider for correlation with clinical findings and potential further testing (urine porphyrins, plasma porphyrins, genetic testing) or treatment. Typical sites of service include hospital outpatient laboratories, independent reference laboratories, emergency departments, and ambulatory clinic specimen collection sites. The patient workflow includes specimen collection (potentially with light protection if required), transport to lab, analytic processing, result verification by a qualified laboratory professional, and release of results to the ordering clinician.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |