How To Use CPT Code 86160

CPT 86160 describes the measurement of complement antigens, such as C1 through C9, which play a crucial role in detecting and fighting infection, as well as evaluating autoimmune conditions. 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 86160?

CPT 86160 can be used to measure levels of complement antigens, including C1 through C9, in order to detect and evaluate infection and autoimmune conditions. This code is used when a lab analyst performs the technical test to analyze serum, plasma, or body fluids for complement antigens using methods such as immunologic quantitation by radial immunodiffusion or immunonephelometry.

2. Official Description

The official description of CPT code 86160 is: ‘Complement; antigen, each component.’

3. Procedure

1. The lab analyst performs the technical test to measure levels of complement antigens in serum, plasma, or body fluids.
2. The test may utilize methods such as immunologic quantitation by radial immunodiffusion or immunonephelometry.
3. The lab analyst analyzes the samples using antibody-antigen reactions to identify the complement antigens.
4. The levels of complement antigens are measured, including components C1 through C9.
5. The results of the test are reported to the healthcare provider for further evaluation and interpretation.

4. Qualifying circumstances

CPT 86160 is used when there is a need to measure levels of complement antigens in order to detect and evaluate infection, autoimmune conditions, or other relevant conditions. This test may be ordered by clinicians to monitor disease conditions such as systemic lupus erythematosus (SLE) or rheumatoid arthritis, or to help diagnose recurrent infections or edema. The test is performed by a lab analyst using specific methods to analyze serum, plasma, or body fluids.

5. When to use CPT code 86160

CPT code 86160 should be used when there is a clinical need to measure levels of complement antigens, such as C1 through C9, in order to detect and evaluate infection, autoimmune conditions, or other relevant conditions. It is important to ensure that the test is performed by a lab analyst using the appropriate methods and techniques.

6. Documentation requirements

To support a claim for CPT code 86160, the healthcare provider must document the following information:

• Reason for ordering the test and the clinical need for measuring complement antigens
• Specific methods used to perform the test, such as immunologic quantitation by radial immunodiffusion or immunonephelometry
• Date and time of the test
• Results of the test, including the levels of complement antigens measured
• Signature of the lab analyst who performed the test

7. Billing guidelines

When billing for CPT code 86160, ensure that the test is performed by a lab analyst using the appropriate methods and techniques. It is important to report one unit for each component of complement antigens measured. Consider any additional guidelines provided by payers or specific coding guidelines for accurate billing.

8. Historical information

CPT code 86160 was added to the Current Procedural Terminology system on January 1, 1993. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst measuring complement antigens, including C1 through C9, in a patient’s serum to evaluate autoimmune conditions.
2. A healthcare provider ordering the measurement of complement antigens to monitor disease conditions in a patient with systemic lupus erythematosus (SLE).
3. A lab analyst performing the test to measure complement antigens in plasma to help diagnose recurrent infections in a patient.
4. A clinician requesting the measurement of complement antigens in body fluids to evaluate edema in a patient.
5. A lab analyst analyzing complement antigens, including components C1 through C9, in serum samples to detect and evaluate infection in a patient.
6. A healthcare provider ordering the measurement of complement antigens to assess the immune response in a patient with autoimmune conditions.
7. A lab analyst performing the test to measure complement antigens in plasma to monitor disease activity in a patient with rheumatoid arthritis.
8. A clinician requesting the measurement of complement antigens in body fluids to help diagnose autoimmune conditions in a patient.
9. A lab analyst analyzing complement antigens, including components C1 through C9, in serum samples to evaluate the immune system function in a patient.
10. A healthcare provider ordering the measurement of complement antigens to assess the response to treatment in a patient with infection.