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Official Description

Very long chain fatty acids

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 82726 refers to a laboratory test specifically designed to measure the levels of very long chain fatty acids (VLCFA) in the blood. VLCFA are a type of fat molecule characterized by their aliphatic tails, which are longer than 22 carbon atoms. These fatty acids play a crucial role in cellular metabolism, particularly in the production of energy. When fatty acids are ingested or when stored triglycerides are released from adipose tissue, they serve as a source of fuel for the mitochondria, the energy-producing organelles within cells. The process of energy production involves the breakdown of these fatty acids through a mechanism known as beta oxidation, which ultimately leads to the generation of adenosine triphosphate (ATP), the primary energy currency of the cell. However, due to their large size, VLCFA require initial processing by peroxisomes—specialized cellular organelles responsible for the breakdown of fatty acids—before they can be utilized for energy by the mitochondria. In certain genetic disorders, particularly those related to adrenoleukodystrophy, the function of peroxisomes is impaired, preventing the effective breakdown of VLCFA. This dysfunction results in an accumulation of VLCFA in the bloodstream, which can have significant health implications. The test involves obtaining a blood sample through a procedure known as venipuncture, which is reported separately. The plasma obtained from the blood sample is then analyzed for VLCFA and branched chain fatty acids using advanced techniques such as liquid chromatography-tandem mass spectrometry, ensuring precise measurement and analysis of these important biomolecules.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The CPT® Code 82726 is indicated for use in the evaluation of conditions associated with the accumulation of very long chain fatty acids in the blood. This test is particularly relevant for diagnosing and monitoring certain genetic disorders, including:

  • Adrenoleukodystrophy - A genetic disorder that affects the metabolism of very long chain fatty acids, leading to their buildup in the body.
  • Peroxisomal disorders - Conditions that impair the function of peroxisomes, resulting in the inability to properly metabolize VLCFA.
  • Neurological symptoms - Patients presenting with neurological symptoms that may be linked to VLCFA accumulation may require this test for further evaluation.

2. Procedure

The procedure for obtaining the CPT® Code 82726 involves several key steps to ensure accurate measurement of very long chain fatty acids in the blood. The process begins with the collection of a blood sample from the patient. This is performed through a technique known as venipuncture, where a needle is inserted into a vein, typically in the arm, to draw blood. It is essential that the blood sample is collected in a manner that prevents contamination and preserves the integrity of the plasma for subsequent analysis.

  • Step 1: Venipuncture - A trained healthcare professional performs venipuncture to obtain a blood sample. The site is cleaned with an antiseptic to minimize the risk of infection, and a tourniquet may be applied to engorge the vein, making it easier to access. Once the needle is inserted and blood is drawn, the tourniquet is released, and the needle is removed.
  • Step 2: Plasma Separation - After collection, the blood sample is placed in a centrifuge, which spins the sample at high speeds to separate the plasma from the cellular components of the blood. The plasma, which contains the very long chain fatty acids, is carefully extracted for analysis.
  • Step 3: Analytical Testing - The separated plasma is then subjected to liquid chromatography-tandem mass spectrometry (LC-MS/MS). This advanced analytical technique allows for the precise measurement of VLCFA and branched chain fatty acids, providing detailed information about their concentrations in the sample.

3. Post-Procedure

Following the procedure for CPT® Code 82726, there are several considerations for post-procedure care. Patients may experience minor discomfort or bruising at the venipuncture site, which typically resolves on its own. It is advisable for patients to apply pressure to the site and keep it clean to prevent any potential complications. The results of the VLCFA test are usually available within a specified timeframe, and healthcare providers will discuss the findings with the patient to determine any necessary follow-up actions or treatments based on the results. Additionally, it is important for patients to inform their healthcare provider of any symptoms or changes in their health status that may arise after the test.

Short Descr LONG CHAIN FATTY ACIDS
Medium Descr VERY LONG CHAIN FATTY ACIDS
Long Descr Very long chain fatty acids
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.
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
GA Waiver of liability statement issued as required by payer policy, individual case
Date
Action
Notes
2021-01-01 Note AMA Guideline removed.
1999-01-01 Added First appearance in code book in 1999.
Code
Description
Code
Description
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