Explaining CPT 82310 usage and definition

What will I learn in this article?

Learn about CPT Code 82310 regarding Pathology and Laboratory Chemistry and Calcium. We go over the definitions, modifiers, bundled codes, places of service, and possible financial physician reimbursements based on 100% and 125% to CMS. Pictures also help further educate. Enjoy!

Formal and Layperson Definitions of CPT Code 82310

We’ve provided both the AMA description as well as the layperson’s definition of CPT Code 82310 below so you can use it for medical notes as well as to easily teach the code to your newer medical coders and billers. 

AMA Definition of CPT Code 82310

Calcium level, total

How to Explain CPT Code 82310 to a New Medical Coder

CPT Code 82310 refers to the "Assay of calcium; total." This code is used in medical billing to represent a laboratory test that measures the total calcium levels in a patient’s blood. Calcium plays a crucial role in many bodily functions, including bone health, muscle function, and nerve signaling. The test helps diagnose and monitor conditions related to abnormal calcium levels, such as kidney disease, parathyroid disorders, or certain cancers. This code is typically used by healthcare providers when submitting claims for reimbursement to insurers for the lab work involved in analyzing calcium levels.

Current CMS Status of CPT Code 82310

STATUTORY EXCLUSION: These codes represent an item or service that is not in the statutory definition of "physician services" for fee schedule payment purposes. No RVUS or payment amounts are shown for these codes, and no payment may be made under the physician fee schedule. (Examples are ambulance services and clinical diagnostic laboratory services.)

82310 CPT Code General Information

82310 cpt code has a diagnostic family of 99, with no age range, and has an MUE Count of “2”, and HOS MUE Count of “4", and this is one of only a handful of everyday codes that can be used in duplicates (but check your current exclusions and contracts to ensure you have adopted duplicates and for which providers this is allowed.)

There are 2 primary Outpatient CCI Bundled Codes for 82310 cpt (see below). They are 82331 (Calcium; total) which became effective 1/1/1996 and requires an override, while 96523 (irrigation of implanted venous access device for drug...) does not require an override. The APC Bundled Code listed at this time is 82331.

82310 CPT Places of Service

There are 49 current POS that could be use ranging from Pharmacy (01), Homeless Shelter (04), Assisted Living (13), Walk-In Retail Health Clinic (17), Urgent Care (20), Inpatient Hospital (21), and many others. To get the full listing enroll IVECoder for Clinics or VirtualAuthTech for Payers.

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Modifiers for CPT Code 82310

There are currently 48 different possible modifiers that can be used in conjunction with CPT Code 82310, some of the most common being 32 for mandated services, 33 for preventive services, 52 for reduced services, AG for primary physician, M for Physician that is a team member svc,  and 91 for repeat clinical diagnosis lab test. For a full listing of all modifiers enroll in VirtualAuthTech (payers) or IVECoder(clinics).

Contractual Rates for 82310 are $0.00

By using iVECoder or Virtual AuthTech we can calculate what cpt code 82310 will be applying 100% to CMS in your territory.  This is actually an illusion because in all reality 82310 should be used in within a bundled code the majority of the time.

However, we've used Idaho as an example showing that you can use our software for not just any single code but for bundled codes as well. By knowing the rates of 100% and 125% to CMS respectively your health plan can set appropriate contract physician reimbursement rates, and as a provider or clinic or hospital you can better negotiate your rates based on those 100-125% of CMS rates.

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