2025 CPT code 80050
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Organ or Disease Oriented Panels Pathology and Laboratory Procedures Feed
The general health panel is a group of clinical laboratory tests including a comprehensive metabolic panel, a complete blood count with differential, and thyroid stimulating hormone (TSH) level.
Modifiers may be applicable depending on the circumstances of service. For example, modifier -91 (repeat clinical diagnostic laboratory test) might apply if the tests are repeated.Modifiers such as -26 (professional component), -TC (technical component), and facility modifiers are also potentially applicable. Refer to the CPT manual and payer specific guidelines for modifier use.
Medical necessity for the general health panel is generally only established when it’s used for screening purposes as part of a routine exam or preventative care; however, payers often deny this usage.Individual tests within the panel will need separate medical justification if ordered for diagnostic reasons.
A lab analyst performs the tests. They may also collect the blood samples.The ordering physician is responsible for medical necessity and interpretation of the results.
In simple words: This lab test is a group of blood tests that check your overall health. It includes tests for things like blood sugar, electrolytes, kidney function, and thyroid function.It also includes a complete blood count that checks for things such as red and white blood cells, and platelets.This panel is rarely done, and often the doctor may order the individual tests instead.
CPT code 80050 represents a general health panel that comprises three essential components: a comprehensive metabolic panel (CMP, code 80053), a complete blood count (CBC) with automated or manual differential (codes 85025, 85027, 85004, 85007, or 85009), and a thyroid-stimulating hormone (TSH) test (code 84443).The CBC can be performed using automated methods (85025 or 85027) combined with automated (85004) or manual (85007 or 85009) differential counts. Alternatively, a manual blood smear (85007 or 85009) can be used for the differential count.All three components must be performed to report 80050.Additional tests performed beyond these components should be reported separately. Note that this panel is rarely ordered due to payer denials for screening purposes.Individual components should be reported if ordered for diagnostic reasons.
Example 1: A 45-year-old woman undergoes a routine general health checkup. Her physician orders the general health panel (80050) as a screening to assess her overall health status.All three components are performed, demonstrating the proper use of the code., A 60-year-old man presents with fatigue, weight loss, and increased thirst. His physician orders individual tests (80053, 84443, and 85025) to investigate these symptoms.Code 80050 is inappropriate; instead, the individual test codes should be billed., A 22-year-old female presents for a pre-employment physical. Her physician orders individual components of the general health panel: CMP, CBC, and TSH. The individual codes for each test should be billed.
Physician order specifying the tests.Lab reports for each component test (CMP, CBC with differential, TSH). Patient demographics and identification information.
** Payer reimbursement for this code is inconsistent.Many payers do not reimburse for 80050 when billed as a general health screening, making billing of the individual components more common.Always consult payer-specific guidelines to ensure accurate billing and reimbursement.
- Revenue Code: T1H (LAB TESTS - OTHER)
- Payment Status: Active, but frequently denied by payers when ordered as a screening panel.
- Modifier TC rule: Technical component (TC) modifiers apply to the laboratory procedures performed.Professional component (-26) modifiers apply to the physician's interpretation and report generation.
- Specialties:Internal Medicine, Family Medicine, Endocrinology
- Place of Service:Office, Hospital (Inpatient/Outpatient), Laboratory, Urgent Care Facility, Clinical Laboratory