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The glucagon tolerance test, identified by CPT® Code 82946, is a laboratory procedure designed to assess the body's response to glucagon, a hormone that plays a critical role in glucose metabolism. This test measures the levels of glucose and lactate in the blood after glucagon administration. Glucagon is produced by the pancreas and functions to elevate blood sugar levels by prompting the liver to release glycogen, a stored form of glucose, through a process known as glycogenolysis. The glucagon tolerance test is particularly useful in the evaluation and diagnosis of glycogen storage diseases, such as von Gierke's disease and Cori's disease, which are characterized by the body's inability to properly store and utilize glycogen. Prior to undergoing the test, patients are required to fast for a minimum of 14 hours to ensure accurate baseline measurements. During the procedure, an intravenous (IV) line may be established, which can be reported separately, to facilitate the administration of glucagon and the collection of blood samples. Blood samples for glucose and lactate levels are collected at specified intervals—30, 60, 90, and 120 minutes post-injection—either from the IV line or through a separately reportable venipuncture. The analysis of serum or plasma for glucose and lactate is conducted using a quantitative enzymatic method, providing essential data for the assessment of the patient's metabolic response to glucagon.
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The glucagon tolerance test is indicated for the evaluation of specific metabolic disorders, particularly those related to glycogen storage. The following conditions may warrant the performance of this test:
The glucagon tolerance test involves several key procedural steps to ensure accurate measurement of glucose and lactate levels following glucagon administration. The procedure is as follows:
After the glucagon tolerance test is completed, patients may be monitored for any immediate reactions to the glucagon administration. It is important to observe the patient for signs of hypoglycemia or other adverse effects. The results of the test will be analyzed and interpreted by the healthcare provider, who will discuss the findings with the patient and determine any further diagnostic or therapeutic steps based on the outcomes of the test.
| Short Descr | GLUCAGON TOLERANCE TEST | Medium Descr | GLUCOSE TOLERANCE TEST | Long Descr | Glucagon tolerance test | 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 |
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| Pre-1990 | Added | Code added. |
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