Summary & Overview
CPT 84207: Pyridoxal 5'-Phosphate (PLP) — Vitamin B6 Level
CPT code 84207 represents a quantitative laboratory assay for pyridoxal 5'-phosphate (PLP), the biologically active form of vitamin B6, typically performed on plasma specimens. The test is clinically important for identifying vitamin B6 deficiency, guiding supplementation, and evaluating metabolic or neurologic conditions in which PLP levels are relevant. Nationally, PLP measurement supports diagnostic decision-making across primary care, neurology, hematology, and metabolic clinics, and is part of panels ordered for nutritional assessment and investigative testing.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what CPT code 84207 covers, the typical clinical settings in which it is performed, and the practical context for its use. The publication provides benchmarks and reimbursement context where available, summarizes relevant policy updates affecting laboratory billing and coverage, and outlines clinical considerations that influence utilization. It also identifies common modifiers associated with laboratory services and notes when additional documentation or medical necessity justification may be required.
Data not available in the input for specific payer rates, associated taxonomies, ICD-10 pairings, and related procedure codes are noted where relevant.
Billing Code Overview
CPT code 84207 describes a laboratory test that measures pyridoxal 5'-phosphate (PLP), the active form of vitamin B6, in a patient specimen such as plasma. The test evaluates a patient’s vitamin B6 status and assists clinicians in diagnosing deficiency, monitoring replacement therapy, or investigating metabolic and neurological conditions linked to B6 levels.
Service Type: Clinical laboratory test — quantitative measurement of a vitamin/cofactor
Typical Site of Service: Clinical laboratory or hospital laboratory
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Clinical & Coding Specifications
Clinical Context
A 42-year-old patient presents to an outpatient primary care clinic with progressive peripheral neuropathy, unexplained anemia, and signs of malabsorption after bariatric surgery. The clinician orders a plasma pyridoxal 5'-phosphate (PLP) level to evaluate vitamin B6 status. The patient has blood drawn in the clinic phlebotomy service; the specimen is labeled, processed, and sent to the hospital clinical chemistry laboratory. A laboratory technologist performs the 84207 assay (pyridoxal phosphate, plasma) using an appropriate analytical method. Results are reported electronically to the ordering provider and incorporated into the electronic medical record. The ordering clinician uses the PLP result alongside other nutritional studies (e.g., B12, folate) and clinical assessment to determine whether vitamin B6 supplementation or further diagnostic evaluation is indicated. Typical sites of service include outpatient clinics, hospital outpatient laboratory draw stations, and independent clinical laboratories performing specialty chemistry testing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional Component | Use when billing only the professional interpretation component if applicable to a lab that splits technical and professional billing in rare consultative contexts |