Summary & Overview
CPT 84157: Total Protein in Non-Serum/Non-Plasma/Non-Urine Specimens
CPT code 84157 represents a laboratory assay that measures total protein in specimens other than serum, plasma, or urine using methods other than refractometry. This code covers quantitative protein analysis in alternative body fluids and is relevant for diagnostic evaluation in settings where serum/plasma testing is not appropriate. Nationally, accurate coding of this service affects laboratory billing, claims adjudication, and clinical documentation for specialty specimen testing. Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for non-serum total protein testing, payer coverage considerations, and typical sites of service. The publication outlines common billing scenarios, available benchmarks where provided, and policy implications for laboratory operations and claims processing. If specific payer policies, modifiers, or related taxonomies are needed, those details are presented in the full document. Data not available in the input will be identified as such in the detailed sections.
Billing Code Overview
CPT code 84157 describes a laboratory test in which a lab analyst measures total protein in a specimen other than serum, plasma, or urine using a laboratory method other than refractometry. This procedure is a clinical laboratory service that evaluates protein concentration in alternative specimen types (for example, cerebrospinal fluid, synovial fluid, or other body fluids) when refractometry is not used.
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Service type: Clinical laboratory quantitative test for total protein using non-refractometry methods
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Typical site of service: Hospital laboratory, independent reference laboratory, or outpatient/ambulatory laboratory setting
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents to an outpatient infusion center with suspected exudative pleural effusion following recent thoracentesis. The treating physician orders laboratory analysis of pleural fluid total protein to help categorize the effusion as transudative or exudative (Light's criteria). A sterile fluid specimen (pleural fluid) is submitted to the hospital clinical laboratory. A laboratory analyst performs 84157 to determine total protein concentration by a method other than refractometry (for example, biuret assay) on the non-serum, non-plasma, non-urine specimen. Results are entered into the laboratory information system and routed to the ordering provider; results help guide further management such as additional diagnostic studies, pleural biopsies, or adjustment of medical therapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional component of lab testing if the lab splits technical and professional components and the professional interpretation is billed separately. |
59 | Distinct procedural service |