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Official Description

Pyruvate kinase

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 84220 refers to a laboratory test that measures the levels of pyruvate kinase, an important enzyme that plays a critical role in the metabolic pathway known as glycolysis. This enzyme is essential for the conversion of glucose into energy within the body's cells. A deficiency in pyruvate kinase can result from a genetic defect, which can significantly impact the body's ability to produce glucose from non-carbohydrate sources, a process known as gluconeogenesis. This deficiency is particularly relevant in erythrocytes, or red blood cells, where it can lead to hemolytic anemia, a condition characterized by the premature destruction of red blood cells. The test is performed on a blood sample that is obtained through a procedure known as venipuncture, which is separately reportable. The analysis of the blood sample is conducted using a quantitative enzymatic method, allowing for precise measurement of pyruvate kinase levels in the bloodstream.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The pyruvate kinase test is indicated for the evaluation of patients who may have a deficiency of the enzyme, which can lead to various clinical conditions. The following are specific indications for performing this test:

  • Hemolytic Anemia This test is often performed in patients presenting with symptoms of hemolytic anemia, where the destruction of red blood cells occurs at a rate faster than they can be produced.
  • Genetic Defects Individuals with a family history of genetic disorders affecting red blood cell metabolism may be tested to determine if a pyruvate kinase deficiency is present.
  • Metabolic Disorders The test may be indicated in the assessment of metabolic disorders that affect glycolysis and energy production in cells.

2. Procedure

The procedure for measuring pyruvate kinase levels involves several key steps, which are outlined below:

  • Step 1: Patient Preparation Prior to the blood draw, the patient may be instructed to avoid certain medications or foods that could affect the test results. It is essential to ensure that the patient is adequately informed about the procedure.
  • Step 2: Venipuncture A qualified healthcare professional performs venipuncture to obtain a blood sample. This involves inserting a needle into a vein, typically in the arm, to collect the necessary volume of blood for testing. The site is cleaned with an antiseptic to minimize the risk of infection.
  • Step 3: Sample Handling Once the blood sample is collected, it is properly labeled and handled according to laboratory protocols to ensure its integrity. The sample is then transported to the laboratory for analysis.
  • Step 4: Quantitative Enzymatic Method In the laboratory, the blood sample is analyzed using a quantitative enzymatic method. This technique allows for the precise measurement of pyruvate kinase levels, providing valuable information regarding the patient's metabolic status.

3. Post-Procedure

After the blood sample has been collected, the patient may experience minor discomfort or bruising at the venipuncture site, which typically resolves quickly. There are no specific post-procedure care instructions required for this test, but patients should be advised to report any unusual symptoms or prolonged discomfort. The results of the pyruvate kinase test will be interpreted by a healthcare provider, who will discuss the findings with the patient and determine any necessary follow-up actions based on the results.

Short Descr ASSAY OF PYRUVATE KINASE
Medium Descr ASSAY OF PYRUVATE KINASE
Long Descr Pyruvate kinase
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.
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.
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
Q4 Service for ordering/referring physician qualifies as a service exemption
Date
Action
Notes
2013-01-01 Changed Medium Descriptor changed.
Pre-1990 Added Code added.
Code
Description
Code
Description
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