Laboratory Test for Measuring Serum Prolactin Levels
CPT® code 84146 is used to report a laboratory test that quantifies the amount of prolactin, a hormone produced by the pituitary gland, in a patient’s serum. This test helps evaluate disorders of the pituitary gland, reproductive system, or hypothalamus. Elevated or decreased prolactin levels can indicate conditions such as prolactinoma, pituitary adenoma, hypothyroidism, infertility, or galactorrhea.
When to Use CPT® Code 84146
Report 84146 when:
- The provider orders a quantitative measurement of serum prolactin.
- The test is performed to evaluate abnormal lactation, menstrual irregularities, infertility, erectile dysfunction, or pituitary dysfunction.
- The result is used to guide diagnosis or management of endocrine or reproductive disorders.
- The laboratory performs a definitive quantitative assay using immunoassay or comparable testing methodology.
This code should not be used for qualitative or screening assays; it represents a specific, quantitative test result.
Documentation Requirements
Proper documentation supports accurate billing and clinical interpretation. Include:
- The clinical indication for testing (e.g., galactorrhea, infertility, amenorrhea, pituitary tumor)
- Date and time of specimen collection
- Specimen type (serum) and testing method used
- Prolactin result value and reference range
- Ordering provider’s name, credentials, and signature
Be sure to link the test to an appropriate ICD-10 code supporting medical necessity.
Billing Guidelines
- CPT® 84146 is a single, quantitative laboratory test and may not be billed more than once per specimen.
- It may be part of a hormonal panel, but can also be ordered individually depending on the clinical need.
- Payers may require documentation of the medical necessity for endocrine or reproductive evaluation.
- Repeat testing should be supported by clinical rationale or ongoing treatment monitoring.
- Ensure accurate linkage of the test to relevant diagnoses to avoid denials.
Example
A provider orders a serum prolactin test for a patient presenting with galactorrhea and menstrual irregularities. The lab performs a quantitative immunoassay, and the result shows elevated prolactin levels consistent with possible pituitary dysfunction. The service is reported using CPT® code 84146 with supporting documentation and relevant diagnostic codes.
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