What is the CPT (Current Procedural Terminology) code for microalbumin screening?

CPT Code for Microalbumin Screening

The CPT code for microalbumin screening is 82043 (Albumin; urine, microalbumin, quantitative).

Understanding Microalbuminuria Testing

Microalbuminuria testing is a critical component of kidney disease screening, particularly for patients with diabetes or hypertension. The test detects small amounts of albumin in urine that are not detectable by standard dipstick methods.

Definition and Measurement Methods

• Microalbuminuria is defined as urinary albumin excretion of 30-299 mg/24h, 30-299 mg/g creatinine on a random spot urine sample, or 20-199 μg/min on a timed collection 1
• Three acceptable methods for microalbuminuria screening include:
  1. Measurement of albumin-to-creatinine ratio in a random spot urine collection (preferred method) 2, 3
  2. 24-hour collection with creatinine, allowing simultaneous measurement of creatinine clearance 2
  3. Timed collection (e.g., 4-hour or overnight) 2

Clinical Significance and Screening Recommendations

• Microalbuminuria is an early marker of diabetic nephropathy and predicts progression to overt nephropathy 3
• It also serves as an independent marker of increased cardiovascular morbidity and mortality 1
• Screening should begin 5 years after diagnosis of type 1 diabetes and at the time of diagnosis for type 2 diabetes 2, 3
• Annual screening is recommended for all diabetic patients who don't have previously demonstrated microalbuminuria 2, 3

Proper Testing Procedure

• First morning void or other morning collections are preferred due to known diurnal variation in albumin excretion 2
• Diagnosis requires confirmation with 2 out of 3 abnormal specimens collected within a 3-6 month period due to day-to-day variability 2, 1
• Standard hospital laboratory assays for urinary protein are not sufficiently sensitive; specific assays for microalbumin are required 2, 1

Common Pitfalls to Avoid

• Single measurements can be misleading; confirmation with multiple samples over time is necessary 1
• Several factors can cause transient elevations in urinary albumin excretion:
  • Exercise within 24 hours of collection 1
  • Urinary tract infections 1
  • Marked hypertension 2
  • Heart failure 2
  • Acute febrile illness 2
  • Marked hyperglycemia 2
• Reagent strips alone may be subject to errors from alterations in urine concentration; they should be confirmed by more specific methods 2

Interpretation of Results

• Normal albumin excretion: <30 mg/g creatinine 3
• Microalbuminuria: 30-299 mg/g creatinine 3
• Macroalbuminuria (clinical albuminuria): ≥300 mg/g creatinine 3

The detection of microalbuminuria should trigger appropriate interventions including optimization of glycemic control, blood pressure management, and consideration of ACE inhibitors or ARBs to reduce the risk of progression to overt nephropathy 3.