Billing and Coding: Lab: Cystatin C Measurement

Cystatin C measurement (CPT 82610) is covered when performed on adult patients (age ≥18) with a creatinine-based eGFR of 45–59 ml/min/1.73 m2 who have no markers of kidney damage, and when the record documents that creatinine-based eGFR is suspected to be inaccurate and that more accurate GFR will inform clinical decisions. Claims must include CPT 82610 with one unit of service and an appropriate ICD-10-CM code, and supporting medical record documentation (legible records, physician/NPP signature, physician requisition, clinical rationale, and demonstration of how results affected the plan of care) must be maintained and available upon request.

"Cystatin C measurement is covered when performed on an adult (age >=18) patient with a creatinine-based eGFR of 45–59 ml/min/1."

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