Summary & Overview
CPT 84586: Vasoactive Intestinal Peptide (VIP) Assay
CPT code 84586 represents a laboratory assay to measure vasoactive intestinal peptide (VIP) in blood. Nationally, measurement of VIP supports diagnosis and management of neuroendocrine and gastrointestinal disorders where VIP levels are clinically relevant. As a specialized chemistry test, it has implications for laboratory service lines, clinical workflows for specimen handling, and payer coverage policies for diagnostic testing.
Key payers reviewed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for VIP testing, typical sites of service, and the types of benchmarks and policy elements that influence coverage and utilization. The publication summarizes common billing modifiers and service-line considerations, highlights where clinical guidance affects test ordering, and outlines the typical payer landscape for this CPT code. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 84586 covers a laboratory assay performed by a lab analyst to measure vasoactive intestinal peptide (VIP), a peptide hormone most commonly assessed in blood samples. This test is a clinical laboratory diagnostic assay used to evaluate disorders associated with abnormal VIP levels, including certain endocrine, gastrointestinal, and neuroendocrine conditions.
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Service type: Clinical laboratory diagnostic assay
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Typical site of service: Clinical laboratory or hospital laboratory (blood specimen collection and analysis)
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred to outpatient laboratory services for measurement of vasoactive intestinal peptide (VIP) to evaluate secretory diarrheal syndromes or suspected VIP-secreting neuroendocrine tumors (VIPomas). The patient presents with profuse watery diarrhea, hypokalemia, and dehydration following initial clinical evaluation by a gastroenterologist or endocrinologist. The clinician orders 84586 (VIP level, serum) to support diagnosis and guide management.
The clinical workflow: the patient arrives at an outpatient phlebotomy or hospital laboratory; blood is drawn into appropriate chilled tubes per lab protocol; the specimen is promptly processed and shipped on ice to the reference laboratory or analyzed on-site. The laboratory analyst performs the 84586 assay and reports quantitative VIP concentration. Results are returned to the ordering clinician and used alongside imaging and other labs (electrolytes, stool studies, chromogranin A) to confirm VIPoma or alternative causes of secretory diarrhea. Documentation includes indication, specimen source, collection time, and result with interpretation in the patient record.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation or oversight of the laboratory test separate from the technical component. |