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Official Description

Pyruvate

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 84210 refers to a laboratory test that measures the levels of pyruvate, also known as pyruvic acid, in blood and cerebrospinal fluid (CSF). Pyruvate is a crucial alpha-keto acid that plays a significant role in cellular energy production, particularly during the citric acid cycle, which is essential for aerobic and anaerobic metabolism. This test is particularly important in the context of diagnosing mitochondrial metabolic disorders, as it helps to assess the metabolic state of the body. The procedure involves the simultaneous collection of blood and CSF samples, which are then analyzed to determine the concentration of pyruvate. The blood sample is obtained through a procedure known as venipuncture, which is reported separately, while the CSF is collected via a lumbar puncture, commonly referred to as a spinal tap, which is also reported separately. The analysis of both whole blood and CSF is conducted using a quantitative enzymatic method, ensuring accurate measurement of pyruvate levels for diagnostic purposes.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The pyruvate test (CPT® Code 84210) is indicated for the evaluation of various metabolic conditions, particularly those related to mitochondrial function. The following conditions may warrant this test:

  • Mitochondrial Metabolic Disorders - These disorders can lead to abnormal energy production, and measuring pyruvate levels can help in diagnosing these conditions.
  • Metabolic Acidosis - Elevated pyruvate levels may indicate issues with metabolic processes, which can contribute to acidosis.
  • Neurological Disorders - Since CSF is analyzed, conditions affecting the central nervous system may also be assessed through this test.

2. Procedure

The procedure for obtaining and testing pyruvate levels involves several key steps, which are detailed below:

  • Step 1: Sample Collection - Blood and cerebrospinal fluid (CSF) samples are collected simultaneously. A healthcare professional performs venipuncture to obtain the blood sample, which is a standard procedure for drawing blood from a vein. This step is crucial as it provides the whole blood necessary for the pyruvate analysis. Concurrently, a lumbar puncture is performed to collect the CSF. This procedure involves inserting a needle into the lower back to access the spinal canal and withdraw a small amount of CSF, which is essential for the test.
  • Step 2: Testing Methodology - Once the samples are collected, they are subjected to a quantitative enzymatic method for analysis. This method allows for precise measurement of pyruvate levels in both the blood and CSF samples. The enzymatic assay is designed to quantify the concentration of pyruvate, providing critical data for the diagnosis of potential metabolic disorders.

3. Post-Procedure

After the collection of blood and CSF samples, patients may experience some minor discomfort or side effects, particularly from the lumbar puncture, which can include headache or soreness at the puncture site. It is important for healthcare providers to monitor patients for any adverse reactions following the procedures. The results of the pyruvate test will typically be available within a specified timeframe, allowing for timely diagnosis and management of any identified metabolic disorders. Follow-up consultations may be necessary to discuss the results and any further diagnostic or therapeutic steps that may be required based on the findings.

Short Descr ASSAY OF PYRUVATE
Medium Descr ASSAY OF PYRUVATE
Long Descr Pyruvate
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
2013-01-01 Changed Medium Descriptor changed.
Pre-1990 Added Code added.
Code
Description
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