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Official Description

Thyroxine; total

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 84436 refers to the laboratory test for total thyroxine, commonly known as T4. This test involves obtaining a blood sample to measure the levels of total thyroxine in the bloodstream. Thyroxine is a crucial hormone produced by the thyroid gland, and it plays a significant role in regulating various metabolic processes in the body. The total thyroxine measurement includes both bound and unbound (free) thyroxine, providing a comprehensive overview of thyroid function. This test is essential for diagnosing thyroid disorders, specifically hyperthyroidism, where the thyroid is overactive, and hypothyroidism, where the thyroid is underactive. The evaluation of total thyroxine levels helps healthcare providers assess the overall functioning of the thyroid gland and determine appropriate treatment options. The methodology employed for this test is electrochemiluminescent immunoassay, which is a sensitive and accurate technique for measuring hormone levels in the blood.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The total thyroxine test (CPT® Code 84436) is indicated for the following conditions:

  • Hyperthyroidism - This condition is characterized by an overactive thyroid gland, leading to excessive production of thyroid hormones, including thyroxine. The test helps in diagnosing and managing this condition.
  • Hypothyroidism - In contrast, hypothyroidism is marked by an underactive thyroid, resulting in insufficient hormone production. Measuring total thyroxine levels aids in the diagnosis and treatment of this disorder.
  • Thyroid Function Assessment - The test is utilized to evaluate overall thyroid function, providing critical information for healthcare providers in determining the health of the thyroid gland.

2. Procedure

The procedure for obtaining a total thyroxine level (CPT® Code 84436) involves several key steps:

  • Step 1: Blood Sample Collection - A healthcare professional will collect a blood sample from the patient, typically via venipuncture. This involves inserting a needle into a vein, usually in the arm, to draw a sufficient amount of blood for testing.
  • Step 2: Sample Preparation - Once the blood sample is collected, it is processed in the laboratory. This may involve separating the serum from the blood cells to prepare it for analysis.
  • Step 3: Testing Methodology - The prepared serum is then subjected to electrochemiluminescent immunoassay methodology. This advanced testing technique allows for the precise measurement of total thyroxine levels in the blood.
  • Step 4: Result Interpretation - After the analysis is complete, the results are interpreted by a qualified healthcare professional. The total thyroxine levels are compared against established reference ranges to determine if they fall within normal limits or indicate a thyroid disorder.

3. Post-Procedure

After the total thyroxine test is performed, there are generally no specific post-procedure care requirements for the patient. However, patients may be advised to wait for the results, which are typically available within a few days. It is important for patients to follow up with their healthcare provider to discuss the results and any necessary further actions or treatments based on the findings. Additionally, if the test indicates abnormal levels of thyroxine, further testing or evaluation may be recommended to assess thyroid function more comprehensively.

Short Descr ASSAY OF TOTAL THYROXINE
Medium Descr ASSAY OF THYROXINE TOTAL
Long Descr Thyroxine; total
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
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.
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.
GA Waiver of liability statement issued as required by payer policy, individual case
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.
GZ Item or service expected to be denied as not reasonable and necessary
GW Service not related to the hospice patient's terminal condition
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
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.
LT Left side (used to identify procedures performed on the left side of the body)
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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.
AY Item or service furnished to an esrd patient that is not for the treatment of esrd
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
GX Notice of liability issued, voluntary under payer policy
Q4 Service for ordering/referring physician qualifies as a service exemption
QJ Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)
QW Clia waived test
RT Right side (used to identify procedures performed on the right side of the body)
SA Nurse practitioner rendering service in collaboration with a physician
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
Date
Action
Notes
2013-01-01 Changed Medium Descriptor changed.
Pre-1990 Added Code added.
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