How To Use CPT Code 86037

CPT 86037 describes the measurement of antineutrophil cytoplasmic antibodies (ANCA) in the serum of a patient. 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 86037?

CPT 86037 can be used to measure the level of antineutrophil cytoplasmic antibodies (ANCA) in a patient’s serum. ANCA is an antibody that targets neutrophils, a type of white blood cell. This test is typically ordered after a positive ANCA screen to quantify the level of antibody present in the specimen. The titer obtained from this test can help clinicians monitor treatment response for autoimmune disorders, such as vasculitis.

2. Official Description

The official description of CPT code 86037 is: ‘Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody.’

3. Procedure

1. The lab analyst performs the technical steps to quantify the level of ANCA in the patient’s serum.
2. The titer test involves detecting the antibody level in serial dilutions of the patient specimen using an immunoassay method.
3. The highest dilution (titer) that still demonstrates the presence of ANCA is reported.

4. Qualifying circumstances

CPT 86037 is used when there is a positive ANCA screen and the clinician wants to measure the titer of specific ANCA antibodies, such as cytoplasmic ANCA (cANCA) or perinuclear ANCA (pANCA). This test is often ordered to aid in the diagnosis and treatment monitoring of autoimmune diseases involving inflammatory blood vessels or inflammatory bowel conditions.

5. When to use CPT code 86037

CPT code 86037 should be used when there is a positive ANCA screen and the clinician wants to measure the titer of specific ANCA antibodies. It is important to use this code instead of less-specific codes, such as 86256, to accurately describe the test performed.

6. Documentation requirements

To support a claim for CPT 86037, the following documentation is required:

• Positive ANCA screen
• Specific ANCA antibodies being tested (cANCA or pANCA)
• Date of the test
• Method used for the titer test (immunoassay)
• Reported titer level

7. Billing guidelines

When billing for CPT 86037, ensure that the test is performed after a positive ANCA screen and that the specific ANCA antibodies being tested are documented. It is important to use this code instead of less-specific codes, such as 86256. Some payers may also pay separately for specimen collection.

8. Historical information

CPT 86037 was added to the Current Procedural Terminology system on January 1, 2022. There have been no updates to the code since its addition.

9. Examples

1. A patient with suspected vasculitis has a positive ANCA screen, and the clinician orders CPT 86037 to measure the titer of cANCA antibodies.
2. After a positive ANCA screen, a patient with inflammatory bowel disease undergoes CPT 86037 to measure the titer of pANCA antibodies.
3. A patient with suspected autoimmune vasculitis has a positive ANCA screen, and the clinician orders CPT 86037 to measure the titer of both cANCA and pANCA antibodies.
4. Following a positive ANCA screen, a patient with suspected vasculitis undergoes CPT 86037 to measure the titer of cANCA antibodies.
5. A patient with inflammatory bowel disease has a positive ANCA screen, and CPT 86037 is performed to measure the titer of pANCA antibodies.
6. After a positive ANCA screen, a patient with suspected autoimmune vasculitis undergoes CPT 86037 to measure the titer of both cANCA and pANCA antibodies.
7. A patient with suspected vasculitis has a positive ANCA screen, and the clinician orders CPT 86037 to measure the titer of cANCA antibodies.
8. Following a positive ANCA screen, a patient with inflammatory bowel disease undergoes CPT 86037 to measure the titer of pANCA antibodies.
9. A patient with suspected autoimmune vasculitis has a positive ANCA screen, and CPT 86037 is performed to measure the titer of both cANCA and pANCA antibodies.
10. After a positive ANCA screen, a patient with suspected vasculitis undergoes CPT 86037 to measure the titer of cANCA antibodies.