How To Use CPT Code 86060

CPT 86060 describes the analysis of antistreptolysin O (ASO) in a patient’s blood sample to detect prior infection by group A Streptococcus. 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 86060?

CPT 86060 can be used to analyze the presence of antistreptolysin O (ASO) in a patient’s blood sample. This test is typically ordered by clinicians to detect prior infection by group A Streptococcus, the bacteria responsible for strep throat, bacterial endocarditis, and glomerulonephritis. The test measures the amount of ASO antibody in the patient’s serum, which may remain elevated even months after the infection has resolved.

2. Official Description

The official description of CPT code 86060 is: ‘Antistreptolysin O; titer.’

3. Procedure

1. The lab analyst performs the technical steps to analyze the patient’s blood sample for the presence of antistreptolysin O (ASO).
2. The analyst may use a latex agglutination test, where the patient’s serum is mixed with latex beads coated with streptolysin O antigen.
3. If ASO antibody is present in the patient’s serum, the latex beads will clump together due to the reaction with the antigen.
4. The analyst performs a titer dilution to approximate the amount of ASO present in the sample.
5. A high ASO titer indicates a recent infection with group A Streptococcus.

4. Qualifying circumstances

CPT 86060 is typically ordered when a clinician suspects a recent serious streptococcus infection, such as strep throat, bacterial endocarditis, or glomerulonephritis. The test helps detect prior infection by group A Streptococcus, and the patient’s serum is used to analyze the presence of ASO antibody.

5. When to use CPT code 86060

CPT code 86060 should be used when a clinician orders the analysis of ASO in a patient’s blood sample to detect prior infection by group A Streptococcus. It is appropriate to use this code when performing the specific test for ASO titer.

6. Documentation requirements

To support a claim for CPT 86060, the documentation should include:

• Reason for ordering the test, such as suspicion of recent streptococcus infection
• Details of the technical steps performed to analyze the patient’s blood sample
• Results of the ASO titer dilution
• Interpretation of the results, indicating a high or low ASO titer
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86060, ensure that the test is performed to analyze the presence of ASO in the patient’s blood sample. It is important to follow the specific guidelines for reporting this code and any associated codes for specimen collection, if applicable. Some payers may require separate reporting for specimen collection using a code such as 36415.

8. Historical information

CPT 86060 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 clinician orders CPT 86060 to analyze the ASO titer in a patient’s blood sample to confirm a recent strep throat infection.
2. A patient with a history of bacterial endocarditis undergoes CPT 86060 to monitor the ASO titer as part of their follow-up care.
3. A clinician suspects glomerulonephritis in a patient and orders CPT 86060 to detect prior streptococcus infection as a possible cause.
4. During a routine check-up, a clinician orders CPT 86060 to screen for any recent streptococcus infections in a patient.
5. A patient presents with symptoms of a streptococcus infection, and CPT 86060 is performed to analyze the ASO titer and confirm the diagnosis.
6. A clinician orders CPT 86060 to monitor the ASO titer in a patient receiving treatment for a recent streptococcus infection.
7. A patient with a history of streptococcus infections undergoes CPT 86060 to assess the ASO titer and evaluate their immune response.
8. As part of a research study, CPT 86060 is performed to analyze the ASO titer in a group of patients with different streptococcus-related conditions.
9. A clinician orders CPT 86060 to analyze the ASO titer in a patient’s blood sample as part of a comprehensive evaluation for possible streptococcus infections.
10. A patient with recurring streptococcus infections undergoes CPT 86060 to monitor the ASO titer and assess the effectiveness of their treatment plan.