Summary & Overview
CPT 84143: 17-Hydroxypregnenolone Assay, Serum
CPT code 84143 identifies a laboratory assay for 17-hydroxypregnenolone, a steroid precursor produced by the adrenal glands. This endocrine assay is clinically important for evaluating suspected congenital adrenal hyperplasia and other disorders of steroidogenesis. As a specialized biochemical test, it is performed by clinical or hospital laboratories and may influence diagnostic pathways and further endocrine testing.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national perspective on the clinical purpose of the test, typical sites of service, and payer coverage context. The content outlines what stakeholders can expect regarding coding use and clinical context, and points to where more detailed benchmarks, reimbursement guidance, and policy updates would be referenced.
This summary is intended for a national audience of clinicians, billing specialists, and policy analysts seeking clear, code-specific context for CPT code 84143 without jurisdictional qualifiers. Data not provided in the input—such as specific payer reimbursement rates, associated taxonomies, or linked ICD-10 diagnoses—is noted where relevant.
Billing Code Overview
CPT code 84143 describes a laboratory assay measuring 17-hydroxypregnenolone concentration in a patient specimen, typically serum. This test evaluates adrenal steroid precursors and can aid in the assessment of congenital adrenal hyperplasia, adrenal enzyme defects, and disorders of steroidogenesis.
Service type: Clinical laboratory test — endocrine steroid assay
Typical site of service: Clinical laboratory or hospital laboratory; specimen collection occurs in an ambulatory clinic, inpatient setting, or outpatient phlebotomy service depending on clinical workflow.
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Clinical & Coding Specifications
Clinical Context
A primary care physician or endocrinologist orders a serum 17-hydroxypregnenolone measurement (84143) for a child or adult presenting with signs of adrenal dysfunction (virilization, ambiguous genitalia in neonates, premature pubarche, unexplained hirsutism, menstrual irregularities) or for evaluation of suspected congenital adrenal hyperplasia (CAH) or adrenal tumor/heterotopia. The clinical workflow begins with the ordering clinician documenting the indication in the chart and obtaining informed consent where required. A phlebotomy technician collects a serum specimen (often in the morning to account for diurnal variation), labels and sends it to the clinical laboratory. The laboratory accessioning staff logs the specimen, a laboratory analyst performs the 84143 assay according to validated methods, and the laboratory issues a result with interpretive comments to the ordering provider. Results may prompt follow-up testing (e.g., serum 17-hydroxyprogesterone, cortisol, ACTH, adrenal imaging) and care coordination with pediatric endocrinology or adult endocrine specialists. Typical site of service is an outpatient clinic, hospital outpatient lab, or hospital inpatient setting where diagnostic endocrine laboratory testing is performed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |