Difference Between Basic (BMP) and comprehensive metabolic panel (CMP) (CPT code 80053)

Basic Metabolic Panel (BMP) – tests that measure blood sugar (glucose) levels, electrolyte and fluid balance, and provide information about kidney function, respiratory function and liver function. A comprehensive metabolic panel (CPT code 80053) includes the following tests. Must contain 10 or more of the following Component Codes for the same patient on the same date of service:

Description of CPT code 80053 (comprehensive metabolic panel)

A comprehensive metabolic panel that includes albumin, bilirubin, total calcium, carbon dioxide, chloride, creatinine, glucose, alkaline phosphatase, potassium, total protein, sodium, alanine amino transferase (ALT) (SGPT), aspartate amino transferase (AST) (SGOT), and urea nitrogen (BUN) is obtained. This test is used to evaluate electrolytes and fluid balance as well as liver and kidney function.

It is also used to help rule out conditions such as diabetes. Tests related to electrolytes and fluid balance include carbon dioxide, chloride, potassium, and sodium. Tests specific to liver function include albumin, bilirubin, alkaline phosphatase, ALT, AST, and total protein. Tests specific to kidney function include BUN and creatinine. Calcium is needed to support metabolic processes such as heart function, muscle contraction, nerve function, and blood clotting. Glucose is the main source of energy for the body and is regulated by insulin. Glucose measurement determines whether the glucose/insulin metabolic process is functioning properly.

80053 Comprehensive metabolic panel

albumin (82040),

total bilirubin (82247),

total calcium (82310),

carbon dioxide (bicarbonate) (82374),

chloride (82435),

creatinine (82565),

 glucose (82947),

alkaline phosphatase (84075),

potassium (84132),

total protein (84155),

sodium (84295),

alanine amino transferase (ALT) (SGPT) (84460),

aspartate amino transferase (AST) (SGOT) (84450),

urea nitrogen (BUN) (84520).

 A comprehensive metabolic panel can also be coded with other panel codes. Let us checkout them one by one.

80048 -A basic metabolic panel with total calcium includes the following tests: total calcium (82310), carbon dioxide (82374), chloride (82435), creatinine (82565), glucose (82947), potassium (84132), sodium (84295), and urea nitrogen (BUN) (84520). The blood specimen is obtained by venipuncture. See the specific codes for additional information about the listed tests.

80053 –Comprehensive Metabolic panel

Basic metabolic panel (80048)

Plus 2 or more of the following Component Codes for the same patient on the same date of service:

albumin (82040),

total bilirubin (82247),

alkaline phosphatase (84075),

total protein (84155),

alanine amino transferase (ALT) (SGPT) (84460),

aspartate amino transferase (AST) (SGOT) (84450)

CPT code 80051 : An electrolyte panel includes the following tests: carbon dioxide (82374), chloride (82435), potassium (84132), and sodium (84295). Blood specimen is obtained by venipuncture. See specific codes for additional information about the listed tests.

80053 Comprehensive Metabolic Panel

Includes the following panel:

 80051 Electrolyte Panel

Plus 6 or more of the following Component Codes for the same patient on the same date of service: 82040 Albumin; serum, plasma or whole blood

82247 Bilirubin; total

82310 Calcium; total

82565 Creatinine; blood

82947 Glucose; quantitative, blood (except reagent strip)

84075 Phosphatase, alkaline

84155 Protein, total, except by refractometry; serum, plasma or whole blood

84450 Transferase, aspartate amino (AST) (SGOT)

84460 Transferase; alanine amino (ALT) (SGPT)

84520 Urea nitrogen (BUN)

CPT Panel Code 80053 includes all of the components of CPT Panel Code 80048 and all the components of CPT Panel Code 80076, except for CPT 82248 (bilirubin, direct). Therefore, when performed with all of the components of CPT 80053, report CPT 82248 separately.

The collection of the specimen by venipuncture (e.g., 36415) is not considered an integral part of the laboratory procedure performed. If both the collection of the specimen(s) by venipuncture and the laboratory procedure(s) are performed, then it would be appropriate to report a code for the collection of the specimen(s) in addition to the appropriate code(s) from the 80000 series for the laboratory procedure(s) performed

NCCI edits for CPT code 80053

Below the edits with CPT code 80053 and use the modifier with the help of modifier indicator to correctly code the codes.

Read also: Difference between 91 and 59 modifier 

Points to remember for CPT code 80053

• Providers may bill either a panel code or an individual code.
• Each panel code comprises multiple tests.
• The panel code should be reported when all individual components in the panel have been performed.
• Do not report two or more panel codes that include any of the same constituent tests performed from the same patient collection.
• If a group of tests overlaps two or more panels, the panel that incorporates the greater number of tests to fulfill the code definition should be reported and the remaining tests should be reported using individual test codes
• If one performs tests in addition to those specifically indicated for a particular panel, those tests should be reported separately in addition to the panel code
• For a CLIA-waived test, append modifier QW.

When to use modifier with CPT code 80053

Q: A physician orders a comprehensive metabolic panel (CPT code 80053) and an additional quantitative blood sample to measure blood glucose level (CPT code 82947). Would the physician report modifier -91 (repeat clinical diagnostic laboratory test) or -59 (distinct procedural service) to indicate that the blood sample was performed separately from the panel?  

A: The physician should report CPT code 80053 for the panel and code 82947 for the additional blood sample with modifier -91. The modifier -91 is necessary to distinguish the additional blood sample from the laboratory panel, since a single blood sample to measure blood glucose level is a component of the comprehensive metabolic panel.

Chapter 10 of the NCCI Manual contains edits that pair CPT codes for laboratory panels (Column One codes) with codes for the individual laboratory tests included in the panels (Column Two codes). These edits may be bypassed by appending an applicable NCCI-associated modifier to the CPT code for the repeat laboratory test performed on the same date as a panel. According to CMS, modifier -91 may be utilized to identify the same test repeated on the same day or a test that is a component of a panel being repeated on the same day.

Related CPT code for 80053

80047 A basic metabolic panel with ionized calcium includes the following tests: calcium (ionized) (82330), carbon dioxide (82374), chloride (82435), creatinine (82565), glucose (82947), potassium (84132), sodium (84295), and urea nitrogen (BUN) (84520). Blood specimen is obtained by venipuncture.

80048 A basic metabolic panel with total calcium includes the following tests: total calcium (82310), carbon dioxide (82374), chloride (82435), creatinine (82565), glucose (82947), potassium (84132), sodium (84295), and urea nitrogen (BUN) (84520). The blood specimen is obtained by venipuncture.

80050 A general health panel includes the following tests: albumin (82040), total bilirubin (82247), calcium (82310), carbon dioxide (bicarbonate) (82374), chloride (82435), creatinine (82565), glucose (82947), alkaline phosphatase (84075), potassium (84132), total protein (84155), sodium (84295), alanine amino transferase (ALT) (SGPT) (84460), aspartate amino transferase (AST) (SGOT) (84450), urea nitrogen (BUN) (84520), and thyroid stimulating hormone (84443). In addition, this panel includes a hemogram with automated differential (85025 or 85027 and 85004) or hemogram (85027) with manual differential (85007 or 85009). Blood specimen is obtained by venipuncture.

80051 An electrolyte panel includes the following tests: carbon dioxide (82374), chloride (82435), potassium (84132), and sodium (84295). Blood specimen is obtained by venipuncture.

80055 An obstetric panel (80055) includes the following tests: hepatitis B surface antigen (HBsAg) (87340), rubella antibody (86762), qualitative non-treponemal antibody syphilis test (VDRL, RPR, ART) (86592), RBC antibody screen (86850), ABO blood typing (86900), and Rh (D) blood typing (86901). In addition, this panel includes an automated complete blood count (CBC) and automated differential white blood count (WBC) as described by 85025 or 85027 and 85004 OR automated CBC (85027) and appropriate manual differential WBC count (85007 or 85009). Blood specimen is obtained by venipuncture. See specific codes for additional information about the listed tests. Report 80081 when the obstetric panel also includes HIV-1 antigen(s) with HIV-1 and HIV-2 antibodies reported as a single result (87389).

80061 A lipid panel includes the following tests: total serum cholesterol (82465), high-density cholesterol (HDL cholesterol) by direct measurement (83718), and triglycerides (84478). Blood specimen is obtained by venipuncture.

80069 A renal function panel includes the following tests: albumin (82040), total calcium (82310), carbon dioxide (bicarbonate) (82374), chloride (82435), creatinine (82565), glucose (82947), inorganic phosphorus (phosphate) (84100), potassium (84132), sodium (84295), and urea nitrogen (BUN) (84520).

80074 An acute hepatitis panel includes the following tests: hepatitis A antibody (HAAb), IgM antibody (86709), hepatitis B core antibody (HbcAb), IgM antibody (86705), hepatitis B surface antigen (HbsAg) (87340), and hepatitis C antibody (86803).

80076 A hepatic function panel includes the following tests: albumin (82040), total bilirubin (82247), direct bilirubin (82248), alkaline phosphatase (84075), protein, total (84155), alanine amino transferase (ALT) (SGPT) (84460), and aspartate amino transferase (AST) (SGOT) (84450). Blood specimen is obtained by venipuncture.

80081 An obstetric panel (80055) includes the following tests: hepatitis B surface antigen (HBsAg) (87340), rubella antibody (86762), qualitative non-treponemal antibody syphilis test (VDRL, RPR, ART) (86592), RBC antibody screen (86850), ABO blood typing (86900), and Rh (D) blood typing (86901). In addition, this panel includes an automated complete blood count (CBC) and automated differential white blood count (WBC) as described by 85025 or 85027 and 85004 OR automated CBC (85027) and appropriate manual differential WBC count (85007 or 85009). Blood specimen is obtained by venipuncture. See specific codes for additional information about the listed tests. Report 80081 when the obstetric panel also includes HIV-1 antigen(s) with HIV-1 and HIV-2 antibodies reported as a single result (87389).