2025 CPT code 82010
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Chemistry Procedures Pathology and Laboratory Procedures > Chemistry Procedures Feed
Quantitative measurement of ketone bodies (e.g., acetone, acetoacetic acid, beta-hydroxybutyrate) in serum or plasma.
Modifiers may apply depending on the circumstances (e.g., modifier 90 for outside laboratory). Consult the current CPT modifier guidelines.
Medical necessity is established when a physician orders a serum ketone test based on clinical suspicion of a metabolic disorder, such as DKA, or in situations where ketone levels need to be monitored (e.g., during the treatment of DKA or in patients with uncontrolled diabetes).
The clinical responsibility lies with the laboratory analyst who performs the biochemical analysis of the blood sample to accurately determine the ketone levels.A physician interprets these results in the context of the patient's clinical presentation to make a diagnosis and treatment plan.
In simple words: This lab test measures the amount of ketone bodies in your blood. Ketones are produced when your body uses fat for energy instead of glucose.High levels can indicate a serious problem, especially in people with diabetes.
This CPT code encompasses the quantitative determination of ketone bodies, specifically acetone, acetoacetic acid, and beta-hydroxybutyrate, in a patient's serum or plasma sample. The test provides a numerical value representing the concentration of these ketone bodies, aiding in the diagnosis and monitoring of conditions such as diabetic ketoacidosis (DKA) and other metabolic disorders.The analysis involves biochemical methods to measure the ketones precisely, differentiating it from qualitative tests.
Example 1: A patient with type 1 diabetes presents to the emergency room with symptoms suggestive of diabetic ketoacidosis (DKA), including nausea, vomiting, and altered mental status. A serum ketone test (82010) is ordered to quantify ketone levels, confirming the diagnosis and guiding treatment., A patient with a history of alcohol abuse is admitted to the hospital with severe nausea, vomiting and abdominal pain.A blood ketone test is ordered to rule out alcoholic ketoacidosis as well as to measure levels of other metabolites in the context of alcohol abuse and potential organ damage., A pregnant woman with uncontrolled gestational diabetes is experiencing symptoms of ketoacidosis, including fatigue and excessive thirst. A serum ketone test (82010) helps in the diagnosis and management of her condition, ensuring the safety of both the mother and fetus.
** Different ketone tests measure one or more ketone bodies, and their results are not interchangeable. The results of this test should be interpreted in the clinical context of the patient’s presentation and history.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: Information on RVUs is not available in the provided text. This would depend on the payer's specific fee schedule and other factors.
- Global Days: Not applicable; this is a laboratory test, not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable; this is a laboratory test; there is no technical component.
- Fee Schedule: Historical fee schedule information is not available in the given data.
- Place of Service:Office, Hospital (Inpatient or Outpatient), Urgent Care Facility, Emergency Room - Hospital,Laboratory