Coding Ahead
CasePilot
Medical Coding Assistant
Case2Code
Search and Code Lookup Tool
CareerCenter
Medical Coding Job Board
Log in Register free account

Need help choosing the right code?

Ask CasePilot about procedures, modifiers, bundling, and coding guidance.

Try CasePilot

Official Description

Pregnancy-associated plasma protein-A (PAPP-A)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 84163 refers to the laboratory test for measuring pregnancy-associated plasma protein-A (PAPP-A) levels in a blood sample. This protein is crucial during pregnancy as it serves as a biomarker for various potential complications. The test is primarily utilized as a screening tool for pregnant women, particularly between the 8 to 14 weeks of gestation. Low levels of PAPP-A can indicate an increased risk for several serious conditions, including intrauterine growth restriction, trisomy 18 and 21, premature delivery, preeclampsia, and stillbirth. To ensure accurate results, it is essential that a nuchal translucency (NT) measurement is performed via ultrasonography prior to conducting the PAPP-A test. This measurement provides critical information that must be documented, including the fetal crown-rump length in centimeters, the date of the ultrasound, the patient's date of birth, current weight, due date, number of fetuses, the patient's race, and any history of previous pregnancies with chromosomal abnormalities. In cases where the pregnancy is achieved through egg donation, the age of the donor must also be recorded. The PAPP-A levels are subsequently analyzed using an enzyme-linked immunosorbent assay (ELISA), which helps in evaluating the risk for the aforementioned complications during the pregnancy.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The PAPP-A test is indicated for use in pregnant women, particularly during the early stages of pregnancy, to assess the risk of various complications. The specific indications for performing the PAPP-A test include:

  • Intrauterine Growth Restriction - Low levels of PAPP-A may indicate a risk for the fetus not growing adequately within the uterus.
  • Trisomy 18 and 21 - The test is used to screen for chromosomal abnormalities such as Down syndrome (trisomy 21) and Edwards syndrome (trisomy 18).
  • Premature Delivery - Low PAPP-A levels can be associated with an increased risk of delivering the baby before the full term.
  • Preeclampsia - The test helps identify women at risk for this pregnancy complication characterized by high blood pressure and potential damage to other organ systems.
  • Stillbirth - Low PAPP-A levels may indicate a higher risk of stillbirth, prompting closer monitoring and management of the pregnancy.

2. Procedure

The procedure for obtaining the PAPP-A test involves several critical steps to ensure accurate results. First, a blood sample is collected from the pregnant woman, typically through venipuncture. This sample is then processed to measure the levels of PAPP-A. Prior to this blood draw, a nuchal translucency (NT) measurement must be performed using ultrasonography. This ultrasound procedure involves measuring the fluid-filled space at the back of the fetus's neck, which is an important indicator of potential chromosomal abnormalities. During the ultrasound, specific data must be collected, including the fetal crown-rump length in centimeters, the date of the ultrasound, the patient's date of birth, current weight, due date, number of fetuses present, the patient's race, and any history of previous pregnancies with chromosomal abnormalities. If the pregnancy is a result of an egg donor, the age of the donor must also be documented. Once the blood sample is obtained, the PAPP-A levels are analyzed using an enzyme-linked immunosorbent assay (ELISA), which quantitatively measures the concentration of the protein in the blood. The results are then evaluated to assess the risk of the aforementioned complications.

3. Post-Procedure

After the PAPP-A test is completed, the patient may resume normal activities without any specific restrictions. It is important for healthcare providers to communicate the results of the test to the patient, as low PAPP-A levels may necessitate further monitoring and evaluation throughout the pregnancy. Depending on the results, additional testing or interventions may be recommended to manage any identified risks. Patients should be informed about the significance of the results and any follow-up appointments that may be required to ensure the health and safety of both the mother and the fetus.

Short Descr PAPPA SERUM
Medium Descr PREGNANCY-ASSOCIATED PLASMA PROTEIN-A
Long Descr Pregnancy-associated plasma protein-A (PAPP-A)
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.
Date
Action
Notes
2011-01-01 Changed Short description changed.
2005-01-01 Added First appearance in code book in 2005.
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"