College of American Pathologists

  Troponin billing rules


Reprinted from December 1998 CAP TODAY

Multiple units of troponin can be billed on the same day, Health Care Financing Administration policy staff has confirmed.

HCFA defines one unit of troponin as one order for troponin (CPT code 84484 or 84512), regardless of the mix of troponin T and I provided. Troponin C is not useful in managing myocardial infarction, HCFA says, but troponin and creatine kinase (CPT codes 82550-82554) are payable to establish MI. Once MI has been established, continued billing of both troponin and CK must be medically justified by the medical record, HCFA staff says.

The policy clarification comes in response to concerns of the College and Texas pathologists regarding an Aug. 1 HCFA program memorandum to Medicare contractors that appeared to limit payment for troponin and preclude payment for both troponin and CK.