Summary & Overview
CPT 84550: Serum Uric Acid Measurement
CPT code 84550 represents a laboratory assay that quantifies uric acid in blood. The test is widely used in clinical practice to evaluate conditions such as gout, renal dysfunction, and disorders of purine metabolism. As a common clinical chemistry procedure, accurate coding for 84550 supports appropriate claims processing, clinical decision-making, and epidemiologic monitoring of related conditions nationwide. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context for ordering this test, typical sites of service where 84550 is performed, and the common payer landscape affecting coverage and claims. The publication summarizes standard coding practice for the procedure, highlights relevant billing considerations, and outlines benchmarks and policy updates that affect laboratory reimbursement and utilization. Where specific data elements are not provided in the input, the text notes that data are not available in the input. The focus is national in scope and intended for billing managers, laboratory directors, and policy analysts seeking a concise reference for this routine clinical chemistry code.
Billing Code Overview
CPT code 84550 measures the amount of uric acid in a patient's blood. This laboratory procedure quantifies serum or plasma uric acid concentration and is used to assess metabolic conditions related to uric acid balance.
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Service type: Clinical chemistry laboratory test
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Typical site of service: Hospital or independent clinical laboratory; may also be performed in outpatient laboratory draw stations or clinic-based labs
Clinical & Coding Specifications
Clinical Context
A 58-year-old male with a history of gout presents to the outpatient clinic for routine monitoring and acute flare evaluation. The clinician orders a serum uric acid level to assess disease control and to guide urate-lowering therapy adjustments. The patient proceeds to the hospital outpatient laboratory or an ambulatory phlebotomy site where a certified medical laboratory scientist or clinical laboratory technician collects a venous blood sample. The lab analyst performs a quantitative assay for serum uric acid using an automated chemistry analyzer. Results are reported to the ordering clinician's outpatient electronic health record and used to determine need for medication titration, additional testing, or counseling on diet and adherence. Typical sites of service include outpatient hospital laboratory, free-standing clinical laboratory, or physician office laboratory where routine chemistry testing is performed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional component of the laboratory test if applicable (rare for automated chemistry tests billed separately). |
52 | Reduced services | Use when the test was partially performed or limited in scope compared with the full service. |