MVMA In-Office Lab List ~ effective _________4/1/98



2003 MVMA In-Office Lab List

80048 Basic metabolic panel

80050 General health panel

80051 Electrolyte panel

80053 Comprehensive metabolic panel

80061 Lipid panel

80069 Renal function panel

80076 Hepatic function panel

81000 Urinalysis, dipstick or reagent tablet; non-automated, with microscopy

81001 Urinalysis, automated, with microscopy

81002 Urinalysis, without microscopy

81015 Urinalysis, microscopic only

81025 Urine pregnancy test

82043 Urine microalbumin, quantitative

82044 Urine microalbumin, reagent strip assay

82247 Bilirubin, total

82248 Bilirubin, direct

82270 Blood, occult; feces(1-3 simultaneous determinations)

82378 CEA (hematologists and oncologists only)

82947 Glucose, quantitative

82948 Glucose, reagent strip

82962 Glucose, blood by glucose monitoring device cleared by FDA for home use

82985 Glycated protein

83001 FSH (endocrinology only)

83002 LH (endocrinology only)

83036 Glycated hemoglobin (Hemoglobin A1C)

83970 Parathyroid hormone (endocrinology only)

84146 Prolactin (endocrinology only)

84153 Prostate specific antigen (PSA)

84403 Testosterone (endocrinology only)

84436 Thyroxin; total (endocrinology only)

84439 Free thyroxin

84443 Thyroid stimulating hormone

84479 Thyroid hormone uptake (T3 or T4) or THBR (endocrinology only)

84480 Triiodothyronine T3; total (TT-3) (endocrinology only)

84481 Free triiodothyronine T3 (endocrinology only)

84702 HCG, quantitative

85007 Blood count; manual differential

85013 Spun microhematocrit

85014 Hematocrit

85018 Hemoglobin

85025 CBC, automated (Hgb, Hct, RBC, WBC and platelet count), and automated differential WBC count

85027 CBC, automated (HGB, Hct, RBC, WBC, and platelet count)

85032 Manual cell count (erythrocyte, leukocyte, or platelet), each (hematologists, oncologists, rheumatologists, pediatric and GYN oncologists only)

85044 Reticulocyte, manual (hematologists, oncologists, pediatric and GYN oncologists only)

85045 Reticulocyte, automated (hematologists, oncologists, pediatric and GYN oncologists only)

85048 leukocyte (WBC), automated

85060 Blood smear, peripheral, interpretation by physician with written report (hematologists, oncologists, pediatric and GYN oncologists only)

85097 Bone marrow smear interpretation only (hematologists, oncologists, pediatric and GYN oncologists only)

85610 Prothrombin time

85651 Sedimentation rate, erythrocyte, non-automated

86376 Microsomal antibodies; each (endocrinology only)

86403 Particle agglutination; screen, each antibody

86580 Intradermal TB

86585 TB tine test

86800 Thyroglobulin antibody (endocrinology only)

87070 Culture, any other source except urine, blood or stool, with isolation and presumptive identification of isolates

87084 Culture, presumptive, pathogenic organisms, with colony estimation from density chart

87086 Culture, bacterial, urine; quantitative, colony count

87177 Ova and parasites, direct smears, concentration and identification

87184 Susceptibility studies, antimicrobial agent, disk method, per plate (12 or fewer agents)

87205 Smear, primary source, with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types

87207 Special stain for inclusion bodies or intracellular parasites (eg. malaria, coccidia, microsporidia, trypanosomes, herpes viruses)

87210 Wet mount for infectious agents (eg. saline, India ink, KOH preps)

87220 Tissue exam by KOH slide of samples from skin, hair or nails for fungi or ectoparasite ova or mites (eg, scabies) (dermatology only)

87880 Streptococcus, group A (infectious agent detection by immunoassay with direct optical observation)

88305 Bone marrow biopsy interpretation ONLY (hematologists, oncologists, pediatric and GYN oncologists only)

88313 Special stains – for iron stains on bone marrow ONLY, with physician evaluation (hematologists, oncologists, pediatric and GYN oncologists

89051 Cell count, miscellaneous body fluids, except blood, with differential count (rheumatologists only)

89060 Crystal identification by light microscopy, with or without polarizing lens analysis, any body fluid except urine (rheumatologists only)

89190 Nasal smear for eosinophils (allergists only)

89300 Semen analysis; presence and/or motility of sperm including Huhner test (post-coital)

89310 Semen analysis, motility and count, not including Huhner test (reproductive endocrinology only)

89320 Semen analysis, complete – volume, count, motility, and differential (urologists only)

89330 Cervical mucus penetration test, with or without spinnbarkeit test (OBGYN only)

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