Summary & Overview
CPT 84160: Total Protein Measurement by Refractometry
CPT code 84160 identifies a laboratory procedure that measures total protein in a specimen using refractometry. Total protein measurement is a common clinical chemistry test used in diagnostic evaluations, disease monitoring, and routine health assessments, making this code broadly relevant across inpatient and outpatient laboratory settings nationwide. The procedure is typically performed in clinical, hospital, and outpatient laboratories and supports a range of clinical decisions from hydration status to liver and renal function assessment.
This analysis covers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code and clinical context, payer coverage considerations, and what information is available for benchmarking. The publication outlines typical sites of service and the clinical utility of total protein by refractometry, and it identifies where input data are not available. Data not available in the input include specific reimbursement rates, associated taxonomies, and ICD-10 linkage. The content is intended to inform billing, coding, and policy teams about the role of CPT code 84160 in laboratory service portfolios and payer interactions at a national level.
Billing Code Overview
CPT code 84160 describes a laboratory measurement in which a lab analyst evaluates the total protein level in any specimen using refractometry. This service is a clinical chemistry laboratory test that quantifies total protein concentration to support diagnosis, monitoring, or general patient assessment.
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Service type: Clinical chemistry laboratory test (total protein by refractometry)
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Typical site of service: Clinical laboratory, hospital laboratory, outpatient laboratory
Clinical & Coding Specifications
Clinical Context
A 58-year-old outpatient with chronic liver disease presents to the outpatient laboratory for routine monitoring of hepatic function and nutritional status. The clinician orders a total protein measurement to assess overall protein status and monitor for hypoalbuminemia or hypergammaglobulinemia. A phlebotomy technician collects a venous blood sample and sends it to the clinical chemistry laboratory. A laboratory analyst performs CPT 84160 by refractometry on serum to determine the total protein concentration. Results are reported into the electronic health record; values assist the ordering clinician in interpreting liver synthetic function, hydration status, and evaluating causes of edema or ascites. Typical sites of service include hospital outpatient laboratories, independent clinical laboratories, and ambulatory clinic labs where basic chemistry testing is performed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing separate professional interpretation for a test that has distinct professional and technical components (rare for refractometry but used if applicable). |
TC |