In 2025, staying current on bundling prevents claim denials and reimbursement errors. The question “is cpt code 82310 bundled in code 84591” matters greatly. You’ll learn payer policies, CMS updates, and practical coding advice here.
What Are CPT 82310 and 84591?
Code 82310 covers a total calcium assay. Code 84591 applies to a vitamin assay (NOS). They both fall under lab codes 80000–89999. However, they don’t bundle automatically together.
2025 Medicare & NCCI Guidance
Medicare classifies both 82310 and 84591 as “active” in its NCCI Policy Manual, effective January 1, 2025. That means each pays separately if documentation supports it :contentReference[oaicite:2]{index=2}.
Panel Bundling Rules
For instance, panel 80053 includes 82310. So, if you submit 80053, Medicare or payers will bundle and deny separate 82310 charges. On the other hand, 84591 typically remains separate and may pay if medically necessary.
Major Payers in 2025
UnitedHealthcare confirms that 82310 is part of some lab panels, like 80053. That means separate submission with a panel leads to bundling. In contrast, 84591 isn’t in standard panels. You can bill it separately if clinical need supports it :contentReference[oaicite:3]{index=3}.
Other commercial payers (e.g. EmblemHealth) follow similar policies. They group component tests under panels. They may deny component codes unless they fall outside bundled panels :contentReference[oaicite:4]{index=4}.
Practical Coding Tips
- Check panel definitions. Confirm if 82310 belongs to a panel on each payer’s fee schedule.
- Document medical necessity. Use clinical rationale when billing 84591 alongside panels.
- Avoid duplicate billing. Don’t submit 82310 separately if a panel already includes it.
- Use modifiers wisely. Modifiers like 59 or EX rarely bypass bundling rules under payer edits.
Examples
Example 1: Panel 80053 Submitted
If you bill panel 80053 with 82310, carriers will bundle 82310. They often deny it or include its cost in the panel payment.
Example 2: Billing Only 84591
If only a vitamin assay is needed, and documentation supports it, 84591 may pay separately. Clearly note why it isn’t part of any panel.
FAQ
Is CPT code 82310 bundled in code 84591?
No. These are two separate tests. 82310 may bundle into a panel like 80053. 84591 stands alone when billed correctly.
Can 84591 be denied if billed with 82310?
Yes—if payers consider both as components of a panel. Review payer-specific policies to avoid denial.
Do modifiers override bundling edits?
Generally not. Carriers seldom let modifiers such as 59 or LT override their component bundling logic.
Conclusion
Ultimately, “is cpt code 82310 bundled in code 84591”? The answer is no: they represent distinct assays. However, 82310 often bundles within panel codes. Meanwhile, 84591 can pay separately if you support the need with documentation. To reduce denials, follow 2025 CMS/NCCI rules and track payer policies closely.
For expert resources on claim denials, ICD‑10 coding tips, or prior authorization, visit our site.