Billing and Coding: Cystatin C Measurement

Cystatin C measurement (CPT 82610) is covered for adult patients with creatinine-based eGFR 45–59 ml/min/1.73 m2 who lack markers of kidney damage and when creatinine-based GFR estimates are believed inaccurate and the result will influence clinical decisions. Claims must include CPT 82610 with 1 unit, an appropriate ICD-10-CM diagnosis supported in the medical record, a physician requisition, legible documentation (H&P, rationale, plan of care), and meet the medical necessity requirements of LCD L37598.

"Cystatin C measurement is covered for adult patients (age >=18) with creatinine-based eGFR 45–59 ml/min/1."

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