CPT 84255: Selenium Quantitative Test in Blood or Urine

CPT code 84255 represents a quantitative laboratory assay for measuring selenium, a trace element relevant to nutritional status and toxicology. This test is commonly ordered to evaluate selenium deficiency, monitor supplementation, or assess potential selenium toxicity. Nationally, accurate measurement of selenium supports clinical decision-making in endocrinology, nutrition, and occupational medicine and informs population-level surveillance of trace element status.

Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find information on clinical context for ordering the test, typical sites of service where the assay is run, and payer coverage considerations. The publication summarizes common billing and coding considerations, available benchmarks where provided, and any notable policy updates that affect laboratory reimbursement and claim processing.

The report is intended for laboratory managers, clinical coders, and policy analysts seeking a concise reference to CPT code 84255, its clinical role, and the payer landscape affecting laboratory services for selenium testing. Data not available in the input is noted where applicable.

Billing Code Overview

CPT code 84255 describes a laboratory test performed by a lab analyst to measure selenium concentration, typically in blood (serum or plasma) or urine specimens. The service type is clinical laboratory testing / quantitative trace element analysis. The typical site of service for this assay is clinical laboratory or hospital laboratory, and it may also be performed in reference laboratory settings for specialized toxicology or nutritional assessments.

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Clinical Context

A typical patient is an adult referred by an internal medicine or occupational health clinician for measurement of selenium status due to concerns about possible deficiency or toxicity. Common scenarios include evaluation of unexplained cardiomyopathy or muscle weakness where selenium deficiency is suspected, monitoring selenium levels in patients receiving total parenteral nutrition, assessing exposure in industrial or environmental contact, or follow-up of patients on high‑dose selenium supplements. The clinical workflow: the ordering clinician documents the indication and orders CPT 84255 (selenium) on the laboratory requisition. A phlebotomist collects a blood specimen (serum or whole blood) or, less commonly, a urine sample per laboratory instructions. The specimen is sent to the clinical chemistry/toxicology laboratory. The laboratory analyst performs the quantitative selenium assay using appropriate methodology (for example, atomic absorption spectroscopy, ICP-MS, or another validated technique). Results are reviewed by laboratory personnel, reported in the electronic health record, and interpreted by the ordering clinician in the context of clinical findings, nutrition status, medication exposures, and potential environmental sources.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the professional (interpretation) portion of the test if split billing applies.

Taxonomy Code	Specialty	Notes
208000000X	Clinical Pathology	Clinical pathologists oversee clinical chemistry and toxicology testing.
207RX0200X	Internal Medicine	Internists commonly order selenium testing for nutritional or cardiomyopathy evaluation.
207Q00000X	Occupational Medicine	Occupational medicine physicians order testing for workplace exposure assessments.
207L00000X	Nutritionist/Dietitian	Registered dietitians collaborate on interpretation for deficiency or supplementation monitoring.
207K00000X	Family Medicine	Primary care clinicians order selenium levels for broader outpatient evaluation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E83.42`	Selenium deficiency	Direct indication for ordering `CPT 84255` to confirm deficiency in symptomatic patients.
`E83.49`	Other disorders of mineral metabolism	Used when a specific trace element disorder is suspected but not otherwise classified.
`E86.0`	Dehydration	May affect serum concentrations and interpretation of selenium levels.
`I51.9`	Heart disease, unspecified	Selenium deficiency can present with cardiomyopathy; used when cardiac symptoms prompt trace element testing.
`T56.8X5A`	Toxic effect of other metals and metalloids, accidental, initial encounter	Used when selenium toxicity from exposure is suspected and testing is performed.
`Z79.2`	Long term (current) use of antibiotics	Included as an example comorbidity that may alter gut flora and nutrient absorption, potentially affecting selenium status.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Specimen collection commonly performed prior to running `CPT 84255`.
`81002`	Urinalysis, non-automated, without microscopy	May be ordered if urine selenium measurement is requested or to assess renal function alongside selenium testing.
`84443`	Thyroid stimulating hormone (TSH)	Often ordered concurrently in broader metabolic or nutritional evaluations when systemic symptoms are present.
`80055`	Battery; routine chemistry (calcium, total protein, albumin, bilirubin, etc.)	Basic metabolic and nutritional panel frequently ordered with trace element testing to assess broader metabolic status.
`83520`	Copper; serum	Other trace element testing commonly performed alongside selenium when evaluating deficiency or toxicity patterns.

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Summary & Overview