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The CPT® Code 82668 refers to a laboratory test specifically designed to measure the level of erythropoietin (EPO) in the serum. EPO is a crucial hormone predominantly produced by the kidneys, which plays a vital role in the regulation of red blood cell production. When blood oxygen levels are low, the kidneys respond by increasing the production of EPO, which is then transported to the bone marrow. In the bone marrow, EPO stimulates hematopoietic stem cells to enhance the production of red blood cells (RBCs), thereby improving oxygen delivery throughout the body. The measurement of serum EPO levels is significant as it can provide insights into various hematological conditions. For instance, abnormal EPO levels can indicate kidney damage or disorders affecting the bone marrow. This test is particularly useful as an initial screening tool for conditions such as polycythemia, which is characterized by an increased number of red blood cells, and for differentiating between various types of anemia. Additionally, it helps in assessing a patient's eligibility for erythropoietin therapy, especially in cases of chronic renal failure. Elevated EPO levels, when accompanied by low hematocrit (HCT) levels, may suggest conditions like iron deficiency anemia or aplastic anemia. Conversely, elevated EPO levels with normal HCT can indicate renal transplant rejection or the presence of benign or malignant kidney tumors. On the other hand, decreased EPO levels may be observed in conditions such as hemochromatosis, while decreased EPO levels alongside elevated HCT are indicative of polycythemia vera. In patients with HIV undergoing AZT therapy, decreased EPO levels are often found in conjunction with decreased HCT. The test is performed on a blood sample obtained through a separately reportable venipuncture, and the serum or plasma is analyzed using a quantitative chemiluminescent immunoassay method.
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The erythropoietin (EPO) test, represented by CPT® Code 82668, is indicated for several clinical scenarios, particularly in the evaluation of hematological conditions. The following are the specific indications for performing this test:
The procedure for measuring erythropoietin levels involves several key steps, ensuring accurate and reliable results. The following outlines the procedural steps:
After the erythropoietin test is performed, there are several considerations for post-procedure care and follow-up. Patients may experience minor discomfort or bruising at the venipuncture site, which typically resolves on its own. It is advisable for patients to monitor the site for any signs of excessive bleeding or infection. The healthcare provider will review the test results and discuss their implications with the patient, including any necessary follow-up tests or treatments based on the findings. If elevated or decreased EPO levels are detected, further diagnostic evaluations may be warranted to determine the underlying cause and appropriate management strategies. Patients should be informed about the importance of adhering to any additional testing or treatment plans as recommended by their healthcare provider.
| Short Descr | ASSAY OF ERYTHROPOIETIN | Medium Descr | ASSAY OF ERYTHROPOIETIN | Long Descr | Erythropoietin | 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 | 233 - Laboratory - Chemistry and Hematology |
| 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. | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GZ | Item or service expected to be denied as not reasonable and necessary | 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. | 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. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | PN | Non-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 | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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