How To Use CPT Code 86592

CPT 86592 is a code for a qualitative syphilis test using non-treponemal antibody detection methods. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 86592 procedures.

1. What is CPT 86592?

CPT 86592 is a code used to represent a specific type of syphilis test that detects non-treponemal antibodies in a patient’s specimen. This test is typically performed using antigen tests such as rapid plasma reagin (RPR), automated reagin test (ART), or Venereal Disease Research Laboratory test (VDRL). The test can be performed on serum or cerebrospinal fluid specimens and is used for initial screening, treatment evaluation, and diagnosis of neurosyphilis.

2. 86592 CPT code description

The official description of CPT code 86592 is: “Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART)”.

3. Procedure

The 86592 CPT code procedure involves the following steps:

1. Collection of patient specimen (serum or cerebrospinal fluid)
2. Mixing the antigen reagent with the patient specimen
3. Evaluating the presence of reagin based on flocculation or aggregation of the antibody/antigen complex
4. Interpreting the test results as positive or negative for syphilis-related antibodies

4. Qualifying circumstances

Patients who are eligible to receive CPT code 86592 services include those who:

• Require initial screening for syphilis
• Need evaluation of syphilis treatment progress
• Are suspected of having neurosyphilis

5. When to use CPT code 86592

It is appropriate to bill the 86592 CPT code when a clinician orders a qualitative non-treponemal antibody test for the detection of syphilis-related antibodies in a patient’s specimen. This may be for initial screening, treatment evaluation, or diagnosis of neurosyphilis.

6. Documentation requirements

To support a claim for CPT 86592, the following information needs to be documented:

• Patient’s medical history and symptoms
• Clinician’s order for the syphilis test
• Type of specimen collected (serum or cerebrospinal fluid)
• Test method used (VDRL, RPR, or ART)
• Test results and interpretation

7. Billing guidelines

When billing for CPT code 86592, keep in mind the following guidelines and tips:

• Some payers may pay separately for collecting the specimen using a code such as 36415 for venipuncture to collect blood or 62270 for lumbar puncture to collect cerebrospinal fluid.
• Distinguish 86592 for the qualitative non-treponemal antibody test from 86593 for the antibody quantification.

8. Historical information

CPT 86592 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2010, with the previous descriptor being “Syphilis test; qualitative (eg, VDRL, RPR, ART)”.

9. Similar codes to CPT 86592

Five similar codes to CPT 86592 and how they differentiate from it are:

• CPT 86593: This code is for the quantification of non-treponemal antibodies, rather than a qualitative test.
• CPT 86780: This code is for a treponemal antibody test, which is typically ordered as a confirmatory test following a positive 86592 result.
• CPT 86602-86804: These codes are for antibody tests related to other infectious agents, not specifically for syphilis.

10. Examples

Here are 10 detailed examples of CPT code 86592 procedures:

1. A patient presents with symptoms suggestive of syphilis, and the clinician orders a qualitative non-treponemal antibody test using the RPR method.
2. A patient with a history of syphilis is undergoing treatment, and the clinician orders a qualitative non-treponemal antibody test using the VDRL method to evaluate treatment progress.
3. A patient with suspected neurosyphilis has a lumbar puncture performed to collect cerebrospinal fluid, which is then tested using the ART method for qualitative non-treponemal antibodies.
4. A patient undergoing routine sexually transmitted infection screening has a blood sample collected and tested for syphilis using the RPR method as part of the initial screening process.
5. A patient with a previous positive syphilis test result has a follow-up qualitative non-treponemal antibody test using the VDRL method to monitor treatment effectiveness.
6. A patient with symptoms of neurosyphilis has a cerebrospinal fluid sample collected and tested using the RPR method for qualitative non-treponemal antibodies.
7. A patient with a history of syphilis has a blood sample collected and tested using the ART method for qualitative non-treponemal antibodies to evaluate treatment progress.
8. A patient undergoing routine sexually transmitted infection screening has a blood sample collected and tested for syphilis using the VDRL method as part of the initial screening process.
9. A patient with a previous positive syphilis test result has a follow-up qualitative non-treponemal antibody test using the ART method to monitor treatment effectiveness.
10. A patient with symptoms of neurosyphilis has a cerebrospinal fluid sample collected and tested using the VDRL method for qualitative non-treponemal antibodies.