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Thyroid Testing


Question

We get an edit for free thyroxine with total thyroxine and thyroid uptake, stating 84436 & 84479 should be rebundled to 84439 (free).  Lab manager states T4 free direct is not included in the total panel. 

Answer

This information is from the NCCI manual:  "Free thyroxine (CPT code 84439) is generally considered to be a better measure of the hypothyroid or hyperthyroid state than total thyroxine (CPT code 84436). 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."

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