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BETA v.3.0

2025 CPT code 82533

Measurement of total cortisol in a patient specimen. Cortisol is a steroid hormone produced by the adrenal glands.

When an analyte is measured in multiple specimens from different sources or at different times, it should be reported separately for each. Cortisol stimulation tests may involve additional codes for other time points (e.g., 80400 for baseline and 30-minute cortisol).

Modifiers may be applicable to specify unusual circumstances or additional procedures associated with the cortisol test. Examples include modifier 90 (reference [outside] laboratory) if sent to an external lab, or modifier 91 (repeat clinical diagnostic laboratory test) for repeat testing.

Medical necessity for total cortisol testing must be supported by relevant signs, symptoms, or conditions that warrant assessment of cortisol levels, such as evaluation of adrenal disorders, monitoring of corticosteroid therapy, or assessment of stress response.

The laboratory analyst processes the patient specimen (blood or urine) and performs the quantitative measurement of total cortisol. They select the appropriate methodology for analysis and ensure accurate results reporting.

IMPORTANT:For free cortisol measurement, use code 82530.For C-peptide testing, use code 84681.

In simple words: This test measures the total amount of cortisol, a stress hormone, in your blood or urine.Cortisol is important for how your body uses sugar, responds to infections, and handles stress.

This code represents the laboratory analysis of total cortisol levels in a provided patient specimen (e.g., serum, urine).Total cortisol includes both protein-bound and free cortisol. Various methodologies may be employed for this analysis, such as liquid chromatography tandem mass spectrometry (LC-MS/MS), radioimmunoassay (RIA), competitive protein binding (CPB), or fluorescent assay.

Example 1: A patient presents with symptoms suggestive of Cushing's syndrome (e.g., weight gain, high blood pressure).A total cortisol test is ordered to assess adrenal gland function., A patient with suspected Addison's disease (adrenal insufficiency) undergoes a total cortisol test to evaluate low cortisol levels., A pregnant patient's cortisol levels are monitored due to physiological changes during pregnancy.

Documentation should include the date and time of specimen collection (important due to cortisol's circadian rhythm), specimen source (serum or urine), and the reason for testing (clinical indication). Any relevant patient history, such as medication use (e.g., corticosteroids) or recent stressors, should also be documented.

** Biotin interference: High levels of biotin intake can interfere with certain cortisol assays and produce inaccurate results. Patients should be instructed to discontinue biotin supplements before testing, if applicable.

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