How To Use CPT Code 84439 (2024)

CPT 84439 is a code used for measuring free thyroxine (T4) levels in a patient’s blood, which can help diagnose thyroid-related conditions. This article will cover the description, procedure, qualifying circ*mstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 84439.

1. What is CPT 84439?

CPT 84439 is a code used in the medical billing and coding field to represent a laboratory test that measures the levels of free thyroxine (T4) in a patient’s blood. Free T4 is the active form of thyroxine that is unbound to proteins in the blood and is produced by the thyroid gland. This test is typically ordered by clinicians to evaluate patients with abnormal thyroid-stimulating hormone (TSH) levels and can help diagnose conditions such as Graves’ disease, Hashimoto’s disease, and other types of hyperthyroidism or hypothyroidism.

2. 84439 CPT code description

The official description of CPT code 84439 is: “Thyroxine; free.”

3. Procedure

  1. A lab analyst collects a patient’s blood sample, typically through venipuncture.
  2. The blood sample is processed to obtain the serum.
  3. The serum is mixed with specific substances to measure the levels of free thyroxine (T4).
  4. Methods such as immunoassay are used to determine the amount of free T4 in the specimen, where patient antibodies react with reagent antigens.
  5. The results are analyzed and reported to the ordering clinician for further evaluation and diagnosis.

4. Qualifying circ*mstances

Patients who are eligible to receive CPT code 84439 services are those with abnormal thyroid-stimulating hormone (TSH) levels or suspected thyroid-related conditions. Clinicians may order this test to further evaluate patients presenting symptoms of hyperthyroidism or hypothyroidism, such as weight changes, fatigue, hair loss, or changes in heart rate. Additionally, patients with a family history of thyroid disorders or those taking medications that can affect thyroid function may also be eligible for this test.

5. When to use CPT code 84439

It is appropriate to bill the 84439 CPT code when a clinician orders a free thyroxine (T4) test to evaluate a patient’s thyroid function and diagnose potential thyroid-related conditions. This test is typically ordered when a patient presents with abnormal TSH levels or symptoms indicative of hyperthyroidism or hypothyroidism. The results of the test can help the clinician determine the appropriate course of treatment for the patient’s condition.

6. Documentation requirements

To support a claim for CPT 84439, the following information should be documented:

  • Patient’s demographic information, including name, date of birth, and insurance information.
  • Ordering clinician’s information, including name, contact details, and National Provider Identifier (NPI) number.
  • Indication for the test, such as abnormal TSH levels or symptoms of thyroid dysfunction.
  • Date and time of the blood sample collection.
  • Method used for the test, such as immunoassay.
  • Results of the free T4 test, including reference ranges for comparison.
  • Any additional relevant clinical information or patient history.

7. Billing guidelines

When billing for CPT code 84439, it is essential to follow the specific guidelines and rules set by the payer. Some payers may pay separately for the collection of the blood sample using a code such as 36415, Collection of venous blood by venipuncture. Additionally, use code 84436, Thyroxine, total, for total thyroxine, which includes both the bound and unbound, or free, T4. Ensure that all required documentation is complete and accurate to support the claim and avoid potential denials or delays in payment.

8. Historical information

CPT 84439 was added to the Current Procedural Terminology system on January 1, 1990. There have been no significant updates to the code since its addition.

9. Similar codes to CPT 84439

Five similar codes to CPT 84439 and how they differentiate are:

  • CPT 84436: This code is used for measuring total thyroxine (T4) levels, which includes both bound and unbound T4.
  • CPT 84443: This code represents a test for thyroid-stimulating hormone (TSH), which is often ordered alongside the free T4 test.
  • CPT 84479: This code is used for measuring unbound (free) triiodothyronine (T3), another hormone produced by the thyroid gland.
  • CPT 84480: This code is for measuring total triiodothyronine (T3) levels, which includes both bound and unbound T3.
  • CPT 84481: This code represents a test for reverse triiodothyronine (rT3), an inactive form of T3 that can provide additional information about thyroid function.

10. Examples

Here are 10 detailed examples of CPT code 84439 procedures:

  1. A patient with a family history of Graves’ disease presents with symptoms of weight loss, increased heart rate, and tremors. The clinician orders a free T4 test to evaluate the patient’s thyroid function.
  2. A patient with a history of hypothyroidism is experiencing fatigue, weight gain, and hair loss. The clinician orders a free T4 test to assess the effectiveness of the patient’s current thyroid medication.
  3. A patient presents with an abnormal TSH level during a routine physical examination. The clinician orders a free T4 test to further evaluate the patient’s thyroid function.
  4. A patient with a history of thyroid cancer undergoes a free T4 test as part of their post-treatment monitoring plan.
  5. A patient taking lithium for bipolar disorder undergoes a free T4 test to monitor potential effects on their thyroid function.
  6. A pregnant patient with a history of hypothyroidism undergoes a free T4 test to ensure proper thyroid function during pregnancy.
  7. A patient with a goiter presents with difficulty swallowing and breathing. The clinician orders a free T4 test to evaluate the patient’s thyroid function.
  8. A patient with a history of Hashimoto’s disease experiences a sudden onset of symptoms indicative of hyperthyroidism. The clinician orders a free T4 test to assess the patient’s thyroid function.
  9. A patient with a family history of thyroid disorders undergoes a free T4 test as part of a preventive screening plan.
  10. A patient with a history of thyroidectomy due to Graves’ disease undergoes a free T4 test to monitor their thyroid hormone replacement therapy.
How To Use CPT Code 84439 (2024)

FAQs

What is CPT code 84439 used for? ›

Group 1
CodeDescription
84439Assay of free thyroxine
84443Assay thyroid stim hormone
84478Assay of triglycerides
84479Assay of thyroid (t3 or t4)
9 more rows

Can CPT 84436 and 84439 be billed together? ›

If free thyroxine is measured, it is not considered appropriate to measure total thyroxine with or without thyroid hormone binding ratio (CPT code 84479). NCCI does not permit payment of CPT codes 84436 or 84479 with CPT code 84439.

What is the CPT code for thyroid removal surgery? ›

Most ENT coders understand how to report a total thyroidectomy (60240), since it entails the surgeon removing the entire thyroid during a single surgical encounter.

What is the CPT code for thyroid cyst excision? ›

CPT® Code 60200 - Excision Procedures on the Thyroid Gland - Codify by AAPC.

Is a thyroid test covered by insurance? ›

The cost of a thyroid panel depends on your insurance coverage and where the test is performed. If ordered by a doctor, insurance normally covers a thyroid panel except for any patient cost-sharing, such as copays or deductibles. Check with your health plan and health care provider for specific cost details.

How often does Medicare pay for a thyroid test? ›

In most instances, Medicare will cover up to two thyroid laboratory tests per year for patients who are clinically stable — that is, not having severe or significant symptoms. However, Medicare may cover more frequent testing for patients who: have had thyroid cancer.

What is CPT code 84436 used for? ›

The lab analyst performs a test to measure the amount of thyroxine, or T4, a hormone that the thyroid gland produces, responsible for growth and developmenttypically. The typical specimen is the patient's blood collected via routine vein puncture.

What diagnosis will cover TSH? ›

APPENDIX CDiagnoses Currently Covered by Medicare for Serum TSH Testing
ICD-9-CM CodePersistent (P), Thyroid (T), or Short-term (S)?Diagnosis
242.00–242.91TThyrotoxicosis with or without goiter
243TCongenital hypothyroidism
244.0–244.9TAcquired hypothyroidism
245.0–245.9TThyroiditis
153 more rows

How to bill for Pathology services? ›

The CPT codes for basic surgical pathology services are in the 88300-88309 series range. These codes, usually based on specimen source and specimen type, are meant to recognize varying degrees of physician effort, practice expense, and malpractice expense associated with the specimen.

What is the ICD for removal of thyroid? ›

There are no specific thyroidectomy ICD codes you can use. However, you can employ the following thyroidectomy-related ICD-10 codes: T81.

What is the procedure code for thyroid? ›

Surgical Procedures on the Thyroid Gland CPT® Code range 60000- 60300.

What is the CPT code for removal of all remaining thyroid tissue? ›

Report code 60260, Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid, and append modifier 50, Bilateral procedure.

What is the name of the surgery for thyroid cyst removal? ›

Thyroidectomy is surgical removal of all or part of the thyroid gland, which is located in the front of the neck. The thyroid gland releases thyroid hormone, which controls many critical functions of the body.

How do you code a cyst excision? ›

CPT codes 11400-11446 should be used when the excision is a full-thickness (through the dermis) removal of a lesion, including margins, and includes simple (non-layered) closure. The provider should use the appropriate CPT code and the diagnosis code should match the CPT code.

What is the medical code for cyst removal? ›

Sebaceous cyst excision

A code for excision of a benign lesion (e.g., 11400), specific to location and size of the cyst, would probably be most appropriate.

What diagnosis code covers thyroid testing? ›

NCD - Thyroid Testing (190.22)

What is a parathyroidectomy CPT? ›

CPT® Code 60500 - Excision Procedures on the Parathyroid, Thymus, Adrenal Glands, Pancreas, and Carotid Body - Codify by AAPC.

What is the CPT code for thyroid stimulating test? ›

Thyroid Stimulating Hormone (TSH)
Test Name:Thyroid Stimulating Hormone (TSH)
CPT Code:84443
Specimen(s) Type:Plasma or Serum
Acceptable Container(s):Tube tops are light green and gold.
Testing Schedule:24 hrs/day, 7 days/week
15 more rows

What is the CPT code for thyroid genetic testing? ›

Group 2
CodeDescription
81546ONCOLOGY (THYROID), MRNA, GENE EXPRESSION ANALYSIS OF 10,196 GENES, UTILIZING FINE NEEDLE ASPIRATE, ALGORITHM REPORTED AS A CATEGORICAL RESULT (EG, BENIGN OR SUSPICIOUS)
81599UNLISTED MULTIANALYTE ASSAY WITH ALGORITHMIC ANALYSIS
1 more row

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