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Official Description

Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 82656 refers to a laboratory test that assesses the presence of pancreatic elastase (EL-1) in fecal samples, providing either a qualitative or semi-quantitative result. Pancreatic elastase is a glycoprotein digestive enzyme produced by the acinar cells of the pancreas. Once synthesized, it is released into the intestine, where it plays a crucial role in the digestion of food, aiding in the absorption of nutrients. Additionally, pancreatic elastase interacts with bile acids and neutral steroids to facilitate the transport of cholesterol within the body. The fecal test for EL-1 is particularly valuable in monitoring pancreatic function, especially in patients diagnosed with cystic fibrosis. Furthermore, this test can assist healthcare providers in diagnosing or ruling out conditions associated with pancreatic exocrine insufficiency, which may arise from chronic pancreatitis, cystic fibrosis, pancreatic tumors, cholelithiasis, or diabetes mellitus. It is important to note that prior to conducting this test, any pancreatic enzyme supplements should be discontinued to ensure accurate results. The test involves collecting a sample of formed stool in a clean container, which is then analyzed using the enzyme-linked immunosorbent assay (ELISA) method. For quantitative measurements of pancreatic elastase, the CPT® Code 82653 should be reported, while CPT® Code 82656 is designated for qualitative or semi-quantitative assessments of EL-1 presence.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The fecal test for pancreatic elastase (EL-1) is indicated for several clinical scenarios, particularly in assessing pancreatic function and diagnosing related conditions. The following are the specific indications for performing this test:

  • Cystic Fibrosis - The test is utilized to monitor pancreatic function in patients diagnosed with cystic fibrosis, a genetic disorder that affects the lungs and digestive system.
  • Chronic Pancreatitis - It assists in diagnosing or excluding pancreatic exocrine insufficiency that may result from chronic pancreatitis, a condition characterized by long-term inflammation of the pancreas.
  • Pancreatic Tumors - The test may help in the evaluation of pancreatic tumors, which can impact the pancreas's ability to produce digestive enzymes.
  • Cholelithiasis - It can be used to assess pancreatic function in patients with gallstones, which may affect the biliary system and pancreatic health.
  • Diabetes Mellitus - The test may also assist in evaluating pancreatic function in individuals with diabetes mellitus, as pancreatic health is crucial for insulin production and glucose metabolism.

2. Procedure

The procedure for conducting the fecal test for pancreatic elastase (EL-1) involves several key steps to ensure accurate results. The following outlines the procedural steps:

  • Step 1: Discontinuation of Pancreatic Enzymes - Prior to testing, it is essential for patients to discontinue any pancreatic enzyme supplements. This step is crucial to avoid interference with the test results, ensuring that the measurement reflects the pancreas's natural function.
  • Step 2: Sample Collection - A sample of formed stool must be collected in a clean container. Proper collection techniques are important to prevent contamination and ensure the integrity of the sample for accurate testing.
  • Step 3: Laboratory Analysis - The collected fecal sample is then analyzed using the enzyme-linked immunosorbent assay (ELISA) method. This laboratory technique allows for the detection and quantification of pancreatic elastase (EL-1) in the feces, providing either qualitative or semi-quantitative results.

3. Post-Procedure

After the fecal test for pancreatic elastase (EL-1) is completed, there are no specific post-procedure care requirements mentioned. However, it is advisable for patients to consult with their healthcare provider regarding the interpretation of test results and any necessary follow-up actions. The results can provide valuable insights into pancreatic function and guide further diagnostic or therapeutic decisions based on the findings.

Short Descr EL-1 FECAL QUAL/SEMIQ
Medium Descr ELASTASE PANCREATIC FECAL QUAL/SEMI-QUANTITATIVE
Long Descr Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative
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) No
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 1
CCS Clinical Classification 235 - Other Laboratory
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.
GZ Item or service expected to be denied as not reasonable and necessary
GA Waiver of liability statement issued as required by payer policy, individual case
GW Service not related to the hospice patient's terminal condition
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2022-01-01 Changed Small & Medium descriptions changed.
2022-01-01 Note Long description grammar change
2011-01-01 Changed Short description changed.
2005-01-01 Added First appearance in code book in 2005.
1992-12-31 Deleted Code deleted.
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Description
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