2025 CPT code 84681
Effective Date: N/A Pathology and Laboratory Procedures > Chemistry Procedures Feed
C-peptide measurement
Modifiers may be applicable depending on the circumstances of the test (e.g., 91 for a repeat test). Modifier 59 may apply to indicate that the C-peptide test is distinct from other services provided during the same encounter.
Medical necessity for a C-peptide test is established when the information is needed to evaluate insulin production, distinguish between different types of diabetes, investigate the cause of hypoglycemia, or monitor the effectiveness of diabetes treatment.
The lab analyst performs the technical steps to measure C-peptide on a blood or urine specimen. They may require a fasting sample as instructed by the physician. Various methods, including immunoassay, may be used for accurate C-peptide measurement.
In simple words: This test measures C-peptide, a substance made along with insulin in your body. It helps doctors understand how much insulin your body is making.
This test measures the level of C-peptide in a blood or urine sample. C-peptide is produced in equimolar amounts with insulin, making it a reliable indicator of insulin production by the pancreas. It helps differentiate between insulin produced by the body (endogenous) and insulin taken through medication (exogenous).
Example 1: A patient with newly diagnosed diabetes undergoes a C-peptide test to help distinguish between type 1 and type 2 diabetes. This helps guide treatment decisions, such as whether insulin injections are necessary., A patient experiencing recurring episodes of hypoglycemia (low blood sugar) undergoes a C-peptide test to investigate the cause. Elevated C-peptide with low blood sugar may suggest an insulinoma (a tumor in the pancreas that overproduces insulin)., A patient with type 2 diabetes who is taking oral medication has their C-peptide levels monitored to assess the effectiveness of the treatment and to determine if their pancreas is still producing insulin.
The required documentation for accurate coding includes the physician's order for the C-peptide test, the patient's medical history related to diabetes and blood sugar regulation, and any related diagnostic test results, such as blood glucose or A1c tests.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- Specialties:Endocrinology, Internal Medicine, Family Medicine, Pediatrics
- Place of Service:Office, Independent Clinic, Hospital (Inpatient or Outpatient), Independent Laboratory