Summary & Overview
CPT 84295: Measurement of Sodium in Serum, Plasma, or Whole Blood
CPT code 84295 represents a laboratory assay to measure sodium concentration in serum, plasma, or whole blood. Sodium measurement is a fundamental electrolyte test used across clinical settings to assess hydration status, electrolyte balance, and contribute to diagnosis and management of many acute and chronic conditions. Nationally, electrolyte testing like this is routinely ordered in inpatient, outpatient, and emergency care, making the code relevant for laboratory operations, billing departments, and payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on the clinical role of the test, expected sites of service, and which payers commonly reimburse this type of laboratory service. The publication outlines billing considerations tied to the code, common modifiers listed in supplied input, and where to locate additional documentation when managing claims for sodium assays.
This summary provides an overview of clinical purpose and billing context for CPT code 84295. The full article offers benchmarks where available, discussion of payer coverage patterns, and operational notes for labs and billing teams. Data not available in the input is clearly indicated where applicable.
Billing Code Overview
CPT code 84295 describes a laboratory test that measures the concentration of sodium in serum, plasma, or whole blood. The procedure is a clinical chemistry assay performed by a laboratory analyst to determine a patient's sodium level, an important electrolyte measurement used in a wide range of clinical assessments.
Service type: Laboratory diagnostic test (clinical chemistry)
Typical site of service: Clinical laboratory, hospital laboratory, or outpatient phlebotomy/collection site
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male presents to the emergency department with weakness, confusion, and persistent vomiting. The treating clinician orders basic serum chemistries, including a serum sodium measurement, to assess for electrolyte disturbances that may explain altered mental status and volume status. A venous blood sample is collected and sent to the hospital core laboratory. The lab analyst performs the quantitative sodium assay (84295) using an automated chemistry analyzer. Results are verified by the laboratory information system, reviewed by clinical laboratory staff, and released to the ordering clinician electronically. The sodium result guides immediate management decisions such as intravenous fluid selection, hypertonic saline administration, or further electrolyte and endocrine evaluation. Typical site of service is an outpatient laboratory draw station, hospital outpatient department, inpatient hospital laboratory, or emergency department point-of-care collection with testing performed in the clinical laboratory.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component (rare for automated chemistry tests). |
59 |