How To Use CPT Code 86215

CPT 86215 describes the laboratory procedure for testing a patient’s serum for antibodies to deoxyribonuclease, also known as anti-DNase. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 86215?

CPT 86215 can be used to describe the laboratory procedure performed by a lab analyst to test a patient’s serum for antibodies to deoxyribonuclease, also called anti-DNase. This test is typically conducted using an immunoassay method, such as enzyme-linked immunosorbent assay (ELISA), to detect the presence of these antibodies in the patient’s blood.

2. Official Description

The official description of CPT code 86215 is: ‘Deoxyribonuclease, antibody.’

3. Procedure

1. The lab analyst collects a serum sample from the patient.
2. The serum sample is then subjected to an immunoassay method, such as ELISA, to detect the presence of antibodies to deoxyribonuclease.
3. The test may involve various steps, including reacting the specimen with test antigens, incubating the mixture, adding an agent to detect the antigen-antibody complex, and interpreting the results as positive, negative, or as a semiquantitative value.

4. Qualifying circumstances

CPT 86215 is typically ordered by clinicians to help diagnose complications or sequelae caused by recent infections with group A Streptococcus bacteria. This test can aid in the diagnosis of conditions such as rheumatic fever or glomerulonephritis, which can occur as a result of untreated or undertreated streptococcal infections. The presence of antibodies to deoxyribonuclease in the patient’s serum can provide valuable information for the clinician in determining the appropriate course of treatment.

5. When to use CPT code 86215

CPT code 86215 should be used when a laboratory performs the immunoassay to evaluate a patient’s serum for antibodies to deoxyribonuclease. It is important to note that this code is specific to the laboratory procedure and does not cover other aspects of patient care or evaluation.

6. Documentation requirements

To support a claim for CPT 86215, the documentation should include:

• Indication for the test, such as suspected complications or sequelae of recent group A Streptococcus infection
• Details of the immunoassay method used, such as ELISA
• Date of the test
• Results of the test, including whether it was positive, negative, or a semiquantitative value
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86215, ensure that the laboratory has performed the immunoassay to evaluate the patient’s serum for antibodies to deoxyribonuclease. It is important to follow the specific guidelines provided by the payer regarding documentation and any additional codes that may be required for specimen collection.

8. Historical information

CPT 86215 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 lab analyst performing an immunoassay to evaluate a patient’s serum for antibodies to deoxyribonuclease.
2. A clinician ordering CPT 86215 to help diagnose complications of recent group A Streptococcus infection in a patient.
3. A lab technician conducting an ELISA test to detect the presence of antibodies to deoxyribonuclease in a patient’s serum.
4. A patient undergoing CPT 86215 to determine if they have developed antibodies to deoxyribonuclease as a result of a recent streptococcal infection.
5. A laboratory performing the immunoassay to evaluate a patient’s serum for antibodies to deoxyribonuclease as part of a comprehensive diagnostic workup.
6. A clinician ordering CPT 86215 to assess the patient’s immune response to a recent streptococcal infection.
7. A lab analyst interpreting the results of an immunoassay for antibodies to deoxyribonuclease in a patient’s serum.
8. A patient’s serum being tested for the presence of antibodies to deoxyribonuclease using an immunoassay method.
9. A laboratory reporting the results of CPT 86215 to the ordering clinician for further evaluation and treatment planning.
10. A clinician using the results of CPT 86215 to guide the management of a patient with suspected complications of a recent streptococcal infection.