Overview
CPT® Code 84550 is used to report a blood test measuring uric acid levels. Uric acid is a waste product of purine metabolism, and elevated or decreased levels can provide critical information for diagnosing gout, kidney disease, metabolic disorders, or other systemic conditions.
CPT 84550 represents the laboratory assay itself. Interpretation, patient counseling, and clinical decision-making are billed separately.
Key Facts About CPT® 84550
- Service type: Clinical chemistry laboratory test
- Provider type: Physicians, laboratories, and qualified healthcare professionals
- Medical services included: Quantitative measurement of uric acid in blood
- Specimen type: Blood (serum or plasma)
- Common clinical indications:
- Diagnosis and monitoring of gout or hyperuricemia
- Evaluation of kidney function or renal disease
- Assessment of metabolic syndrome or cardiovascular risk
- Monitoring uric acid–lowering therapy
- Investigation of unexplained joint pain or kidney stones
When to Use CPT® 84550
CPT 84550 is appropriate when:
- A blood sample is collected for quantitative uric acid measurement
- The test is medically necessary for diagnosis, monitoring, or treatment decisions
- Results are used to guide patient care or therapeutic interventions
Examples:
- Monitoring uric acid levels in a patient with chronic gout
- Assessing kidney function in a patient with nephrolithiasis
- Screening metabolic abnormalities in patients with high cardiovascular risk
- Evaluating recurrent arthritis with suspected hyperuricemia
Documentation Requirements
To properly support CPT 84550 billing, documentation should include:
- Patient identifiers and date of specimen collection
- Clinical indication for uric acid testing
- Laboratory methodology (if required by payer)
- Test results and reference ranges
- Follow-up recommendations or treatment plans
Comprehensive documentation ensures medical necessity, compliance, and longitudinal tracking of metabolic or renal conditions.
Reimbursement and Coding Considerations
- CPT 84550 is generally covered by Medicare, Medicaid, and commercial insurers when medically necessary
- Interpretation and management services are billed separately
- Frequency limitations may apply for routine screening tests
- Always verify payer-specific rules for metabolic and renal lab testing
How OptiMantra Supports Laboratory Testing and Monitoring
OptiMantra’s integrated EMR and practice management platform streamlines documentation, tracking, and billing for lab tests like CPT 84550.
With OptiMantra, providers can:
- Automatically link uric acid orders to the patient’s chart
- Track longitudinal results for ongoing monitoring of gout, kidney function, or metabolic disorders
- Document clinical indications and follow-up plans using structured templates
- Generate audit-ready, compliant billing codes
- Integrate lab results into broader patient care plans
By centralizing lab tracking, documentation, and billing, OptiMantra ensures accuracy, compliance, and efficient workflows for metabolic and renal testing services.
Try OptiMantra for free here!
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