2025 CPT code 84703
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Chemistry Procedures Pathology and Laboratory Procedures Feed
Qualitative test for human chorionic gonadotropin (hCG).
Modifiers may apply depending on the circumstances of the service, such as modifier 90 for outside laboratory services or modifiers 91 and 99 if required.
Medical necessity for code 84703 is established based on the clinical indication, which may include but is not limited to evaluating for pregnancy, detecting or monitoring ectopic pregnancy, and screening for or following up on conditions associated with elevated or decreased hCG levels.Appropriate documentation supporting the medical need must be available.
The clinical responsibility lies with the laboratory analyst who performs the technical aspects of the test, including specimen handling, assay execution, and result interpretation according to established laboratory protocols. The ordering physician is responsible for medical decision-making based on the results.
In simple words: This lab test checks for a hormone called hCG in your blood.A high level of this hormone usually means you're pregnant. This test can also be used to check for other conditions.
This CPT code represents a qualitative assay to detect the presence of human chorionic gonadotropin (hCG) in a patient specimen, typically blood.The method may involve techniques such as electrochemiluminescence immunoassay (ECLIA), which uses a sandwich antigen-antibody reaction with two hCG-specific monoclonal antibodies.The test provides a positive or negative result indicating the presence or absence of hCG,useful in diagnosing pregnancy, evaluating for ectopic pregnancy, monitoring hCG-producing tumors, and screening for Down syndrome.The test is not limited to these uses.
Example 1: A woman suspects she is pregnant and requests a pregnancy test. A blood sample is sent to the lab and tested using code 84703 resulting in a positive result, confirming her pregnancy. , A patient presents with symptoms suggestive of an ectopic pregnancy. The physician orders an hCG test (84703) to assess the levels of hCG which informs the diagnosis and further management. , A patient with a history of gestational trophoblastic disease undergoes regular monitoring for hCG levels to detect recurrence or persistence of disease.The 84703 test helps to track changes in hCG and inform treatment decisions.
* Patient demographics* Ordering physician information* Date and time of specimen collection* Specimen type (blood)* Test result (positive or negative)* Method used for analysis (if applicable)* Relevant clinical information related to the indication for the test.
** Refer to the AMA CPT manual for the most up-to-date information and coding guidelines.Always ensure appropriate documentation supports medical necessity and accurate coding.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: This information is not available in the provided source and would need to be obtained from a fee schedule or other relevant payment databases.
- Payment Status: Active
- Modifier TC rule: This code does not have a technical component (TC) modifier.
- Fee Schedule: This information is not provided and can be obtained from historical fee schedules or other relevant payment databases.
- Specialties:Obstetrics and Gynecology, Oncology, Endocrinology
- Place of Service:Office, Hospital (Inpatient/Outpatient), Laboratory, Urgent Care Facility