How To Use CPT Code 86000

CPT 86000 describes the analysis of febrile agglutinins in a blood specimen to detect specific antibodies for diseases such as Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus, and others. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 86000?

CPT 86000 can be used to analyze a blood specimen for febrile agglutinins, which are antibodies that cause clumping of red blood cells. This test helps in the diagnosis of diseases such as Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus, and others. The test is performed to detect the presence of specific agglutinins caused by these microbes or diseases. Each antigen tested should be reported with this code.

2. Official Description

The official description of CPT code 86000 is: ‘Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen.’

3. Procedure

1. The lab analyst performs the technical steps to analyze a blood specimen for febrile agglutinins.
2. The analyst mixes the blood sample with the reagent for a specific antigen, such as Brucella.
3. The mixture is warmed and examined for agglutination or clumping of red blood cells.
4. If clumping occurs at warm temperatures and separates when cooled, the result is considered positive.
5. If the specimen shows clumping, it is diluted to determine the titer or concentration of the positive results.

4. Qualifying circumstances

CPT 86000 is performed when a patient has a fever of unknown origin that does not resolve with standard treatment. It helps in the diagnosis of diseases caused by specific microbes, such as Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus, and others. The test is performed by a lab analyst who performs all the technical steps to detect the presence of febrile agglutinins in the blood sample.

5. When to use CPT code 86000

CPT code 86000 should be used when analyzing a blood specimen for febrile agglutinins caused by specific diseases or microbes. It is appropriate to use this code when the patient has a fever of unknown origin that requires further investigation. This code should be reported for each antigen tested separately.

6. Documentation requirements

To support a claim for CPT 86000, the documentation should include:

• Reason for ordering the test, such as a fever of unknown origin
• Specific antigens tested, such as Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus, etc.
• Date of the test
• Results of the test, including the presence or absence of agglutination and the titer or concentration of positive results
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86000, ensure that the test is performed by a lab analyst and that the documentation supports the medical necessity of the test. It is important to report this code for each antigen tested separately. Some payers may also reimburse for the collection of the blood specimen using a separate code, such as 36415 for venipuncture.

8. Historical information

CPT 86000 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient with a persistent fever undergoes CPT 86000 to analyze febrile agglutinins caused by Brucella.
2. A patient with symptoms suggestive of Q fever undergoes CPT 86000 to detect febrile agglutinins specific to this disease.
3. A patient with suspected Rocky Mountain spotted fever undergoes CPT 86000 to analyze febrile agglutinins associated with this disease.
4. A patient with a fever of unknown origin undergoes CPT 86000 to detect febrile agglutinins caused by Francisella.
5. A patient with symptoms indicative of scrub typhus undergoes CPT 86000 to analyze febrile agglutinins specific to this disease.
6. A patient with suspected Murine typhus undergoes CPT 86000 to detect febrile agglutinins associated with this disease.
7. A patient with a persistent fever undergoes CPT 86000 to analyze febrile agglutinins caused by a specific microbe.
8. A patient with symptoms suggestive of a specific disease undergoes CPT 86000 to detect febrile agglutinins associated with that disease.
9. A patient with a fever of unknown origin undergoes CPT 86000 to analyze febrile agglutinins caused by a specific microbe.
10. A patient with symptoms indicative of a specific disease undergoes CPT 86000 to detect febrile agglutinins associated with that disease.