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Official Description

Thyroxine binding globulin (TBG)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 84442 refers to the laboratory test for measuring thyroxine binding globulin (TBG) levels in the blood. TBG is a specific protein that plays a crucial role in the transport of thyroid hormones, specifically thyroxine (T4) and triiodothyronine (T3). It is one of three primary proteins responsible for binding these hormones, alongside transthyretin and albumin. The binding of thyroid hormones to these proteins renders them inactive, meaning they do not exert any physiological effects on the body. Therefore, the measurement of TBG is significant as it helps to differentiate between variations in thyroid hormone levels that may be due to changes in TBG concentration rather than actual thyroid function. In cases where individuals exhibit abnormal levels of total thyroid hormones, either elevated or decreased, the TBG test can assist healthcare providers in determining whether these changes are indicative of a thyroid disorder, such as hypothyroidism or hyperthyroidism, or simply a result of variations in TBG levels. The test is conducted using chemiluminescent immunoassay methodology, which is a sensitive and specific technique for quantifying TBG in the serum.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The thyroxine binding globulin (TBG) test, coded as CPT® 84442, is indicated for the evaluation of thyroid function in patients who may present with abnormal thyroid hormone levels. The following conditions may warrant the performance of this test:

  • Evaluation of Thyroid Disorders The TBG test is utilized to help determine whether a patient has an underactive thyroid (hypothyroidism) or an overactive thyroid (hyperthyroidism) that requires treatment.
  • Assessment of Abnormal Thyroid Hormone Levels In individuals exhibiting high or low levels of total thyroid hormones T3 and T4, the TBG test can clarify whether these variations are due to changes in TBG concentration or actual thyroid dysfunction.
  • Investigation of Inherited or Acquired Variations The test may be indicated in cases where there is a suspicion of inherited or acquired variations in the concentration of TBG and other thyroid binding proteins.

2. Procedure

The procedure for conducting the TBG test involves several key steps to ensure accurate measurement of thyroxine binding globulin levels. The following outlines the procedural steps:

  • Step 1: Patient Preparation Prior to the test, the patient may be instructed to avoid certain medications or supplements that could interfere with the results. It is essential to gather a complete medical history to identify any factors that may affect TBG levels.
  • Step 2: Blood Sample Collection A blood sample is obtained from the patient, typically through venipuncture. The blood is collected into a tube that is appropriate for serum testing, ensuring that the sample is handled according to laboratory protocols to prevent contamination or degradation.
  • Step 3: Laboratory Analysis The collected serum is then subjected to analysis using chemiluminescent immunoassay methodology. This technique allows for the sensitive and specific quantification of TBG levels in the serum.
  • Step 4: Result Interpretation Once the analysis is complete, the laboratory will provide the results, which will be interpreted by the healthcare provider in the context of the patient's clinical picture and other thyroid function tests.

3. Post-Procedure

After the TBG test is performed, there are generally no specific post-procedure care requirements for the patient. The patient may resume normal activities immediately following the blood draw. However, it is advisable for the healthcare provider to discuss the results with the patient once they are available, as this will help in determining any necessary follow-up actions or treatments based on the TBG levels and overall thyroid function assessment.

Short Descr ASSAY OF THYROID ACTIVITY
Medium Descr ASSAY OF THYROXINE BINDING GLOBULIN
Long Descr Thyroxine binding globulin (TBG)
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.
GA Waiver of liability statement issued as required by payer policy, individual case
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
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
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