82947

Glucose; quantitative, blood (except reagent strip)

The CPT code 82947 describes the laboratory procedure for quantitative measurement of glucose levels in a blood sample. This test is performed using automated analyzers and enzymatic methods (e.g., glucose oxidase or hexokinase), providing a precise numerical value for blood glucose concentration. This code specifically excludes glucose testing performed using reagent strips, which are typically point-of-care tests. The quantitative blood glucose test is a fundamental diagnostic and monitoring tool for various metabolic conditions, most notably diabetes mellitus and hypoglycemia.

Clinical Indications

  • Diagnosis of diabetes mellitus (Type 1, Type 2, gestational diabetes, and other specific types of diabetes).
  • Monitoring of glycemic control in patients with established diabetes mellitus, including those on insulin or oral hypoglycemic agents.
  • Evaluation of symptoms suggestive of hypoglycemia (e.g., shakiness, sweating, confusion, lightheadedness).
  • Screening for diabetes in asymptomatic individuals with risk factors.
  • Assessment of metabolic status in patients with conditions such as pancreatitis, endocrine disorders, liver disease, or sepsis.
  • Monitoring glucose levels during parenteral nutrition.
  • Emergency evaluation of altered mental status, suspected diabetic ketoacidosis, or hyperosmolar hyperglycemic state.
  • Evaluation of glucose metabolism in patients receiving certain medications that may affect blood glucose levels.

Procedure Steps

  1. Patient preparation, which may include fasting instructions depending on the clinical indication (e.g., fasting glucose vs. random glucose).
  2. Collection of a venous blood sample by venipuncture, typically into a tube containing an anticoagulant (e.g., fluoride to prevent glycolysis).
  3. Laboratory processing of the blood sample, including centrifugation to separate plasma or serum from cellular components.
  4. Quantitative analysis of glucose in the plasma or serum using an automated chemical analyzer employing enzymatic reactions (e.g., glucose oxidase or hexokinase methods).
  5. Performance of quality control procedures to ensure accuracy and precision of the test results.
  6. Interpretation of the quantitative glucose value against established reference ranges relevant to the patient's condition and fasting status.
  7. Reporting of the final blood glucose concentration to the requesting clinician.

Coding Guidelines

  • Code 82947 is used for quantitative, laboratory-based blood glucose measurements. It should not be used for glucose testing performed using reagent strips (e.g., point-of-care testing at the bedside or by patients at home).
  • When multiple glucose measurements are performed on the same day for different clinical indications (e.g., a fasting glucose and then a post-prandial glucose), each quantitative measurement may be reported with 82947, provided medical necessity is clearly documented for each test.
  • For glucose tolerance tests (GTTs), specific codes apply: 82951 (post glucose dose, each additional specimen), and 82952 (for GTT, three specimens including post dose, excludes 82947 and 82951). Note that 82947 may be considered included in the initial specimen for GTTs when codes 82951 or 82952 are used.
  • Medical necessity for performing the blood glucose test must be clearly documented in the patient's medical record.
  • Consider payer-specific policies regarding frequency limits for glucose testing.

Associated ICD-10 Codes