Need help choosing the right code?
Ask CasePilot about procedures, modifiers, bundling, and coding guidance.
Try CasePilot© Copyright 2026 American Medical Association. All rights reserved.
A receptor assay is a laboratory test conducted to evaluate the presence of specific receptors on tumor cells, which can indicate how the tumor may respond to certain therapies. In the context of CPT® Code 84238, this assay focuses on non-endocrine receptors, which are distinct from endocrine receptors that are typically associated with hormones like estrogen or progesterone. The presence of these receptors is crucial because they can influence the growth and behavior of cancer cells. Receptors are specialized molecules located on the surface of cells that bind to specific substances, such as hormones, and transmit signals that can affect cell growth and reproduction. When a tumor is tested for non-endocrine receptors, the results can help determine whether the cancer cells are dependent on non-endocrine hormones for their growth. Tumors that are receptor negative for the specific non-endocrine hormone being tested are less likely to respond to therapies targeting those receptors, while receptor positive tumors may be more amenable to treatment options that are designed to interact with those non-endocrine receptors. This distinction is vital for tailoring effective treatment strategies for patients with cancer.
© Copyright 2026 Coding Ahead. All rights reserved.
The receptor assay, specifically CPT® Code 84238, is indicated for the evaluation of tumors to determine the presence of specific non-endocrine receptors. This assay is performed in the following scenarios:
The procedure for conducting a receptor assay under CPT® Code 84238 involves several key steps to ensure accurate results. First, a sample of tumor tissue is obtained, typically through a biopsy, which is then prepared for analysis. This preparation may include processing the tissue to isolate the cells and preserve their structural integrity. Next, the assay is performed to detect the presence of specific non-endocrine receptors on the surface of the tumor cells. This is achieved through various laboratory techniques, such as immunohistochemistry, which utilizes antibodies that bind to the receptors of interest. The binding of these antibodies is then visualized, allowing for the determination of receptor positivity or negativity. The results are carefully interpreted by a pathologist, who assesses the extent of receptor expression and provides a report that details the findings. This report is crucial for oncologists and other healthcare providers in making informed decisions regarding the most effective treatment strategies for the patient.
After the receptor assay is completed, the results are typically reviewed in conjunction with other clinical information to guide treatment decisions. Patients may not require specific post-procedure care related to the assay itself, but they should be monitored for any potential complications from the biopsy procedure, such as bleeding or infection at the biopsy site. The healthcare provider will discuss the findings with the patient, explaining the implications of receptor positivity or negativity for treatment options. This discussion is essential for developing a personalized treatment plan that aligns with the patient's specific cancer characteristics and overall health status.
| Short Descr | ASSAY NONENDOCRINE RECEPTOR | Medium Descr | RECEPTOR ASSAY NON-ENDOCRINE SPECIFY RECEPTOR | Long Descr | Receptor assay; non-endocrine (specify receptor) | 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 | 3 | 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. | Q4 | Service for ordering/referring physician qualifies as a service exemption | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2011-01-01 | Changed | Short description changed. |
| 2006-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.