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The CPT® Code 82247 refers to a laboratory test that measures the total bilirubin levels in the blood. Bilirubin is a yellowish pigment that is produced during the normal breakdown of red blood cells (RBCs). When RBCs are destroyed, hemoglobin is released and subsequently broken down into bilirubin. This process results in the formation of two types of bilirubin: unconjugated (or indirect) bilirubin, which is not water-soluble, and conjugated (or direct) bilirubin, which is water-soluble. Unconjugated bilirubin is transported to the liver bound to albumin, where it undergoes a transformation to become conjugated by attaching to sugar molecules. This conjugated bilirubin can then be excreted from the liver into the small intestine, where it is further processed and ultimately eliminated from the body in feces as stercobilin. The total bilirubin measurement encompasses both the conjugated and unconjugated forms, providing a comprehensive overview of bilirubin levels in the body. This test is crucial for diagnosing and monitoring various medical conditions, including liver disorders, hemolytic anemia, and physiologic jaundice in newborns. The test is performed by obtaining a blood sample through venipuncture or heel stick, and in some cases, other body fluids such as cerebrospinal fluid may also be analyzed for total bilirubin. The analysis is conducted using quantitative spectrophotometry, a method that quantifies the concentration of bilirubin in the serum or plasma.
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The total bilirubin test (CPT® Code 82247) is indicated for various clinical scenarios, particularly for diagnosing and monitoring specific medical conditions. The following are the primary indications for this laboratory test:
The procedure for obtaining a total bilirubin measurement involves several key steps, which are outlined below:
After the total bilirubin test is performed, the results are typically available within a short timeframe, allowing for timely clinical decision-making. Patients may experience minimal discomfort at the site of blood collection, but no specific post-procedure care is generally required. However, it is important for healthcare providers to monitor the results closely, especially in cases involving newborns or patients with suspected liver disorders, to determine the need for further evaluation or intervention based on the bilirubin levels obtained.
| Short Descr | BILIRUBIN TOTAL | Medium Descr | BILIRUBIN TOTAL | Long Descr | Bilirubin; total | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | CLIA Waived (QW) | Yes | APC Status Indicator | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 2 | CCS Clinical Classification | 233 - Laboratory - Chemistry and Hematology |
| QW | Clia waived test | GA | Waiver of liability statement issued as required by payer policy, individual case | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | GW | Service not related to the hospice patient's terminal condition | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q4 | Service for ordering/referring physician qualifies as a service exemption | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | RT | Right side (used to identify procedures performed on the right side of the body) | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner |
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Notes
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| 2011-01-01 | Changed | Short description changed. |
| 1999-01-01 | Added | First appearance in code book in 1999. |
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