How To Use CPT Code 86255

CPT 86255 describes the screening of a patient’s blood for the presence of antibodies to a noninfectious agent using a fluorescent method. 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 86255?

CPT 86255 can be used to describe the screening of a patient’s blood, typically serum, for the presence of antibodies to a noninfectious agent using a fluorescent method. This code is used when a lab analyst performs an immunoassay test to detect the antigen-antibody reaction in the patient’s sample.

2. Official Description

The official description of CPT code 86255 is: ‘Fluorescent noninfectious agent antibody; screen, each antibody.’

3. Procedure

1. The lab analyst collects a sample of the patient’s blood, typically serum.
2. The analyst performs an immunoassay test using a fluorescent method to screen the patient’s sample for the presence of antibodies to a noninfectious agent.
3. The test may involve reacting the specimen with test antigens, incubating the mixture, adding a fluorescent agent to detect the antigen-antibody complex, and reading the reaction with a fluorescence microscope or viewer.
4. The analyst interprets the results of the test as positive or negative, indicating the presence or absence of antibodies to the noninfectious agent.

4. Qualifying circumstances

CPT 86255 is used when a patient’s blood is screened for antibodies to a noninfectious agent. This test may be ordered by clinicians to diagnose various conditions, such as autoimmune diseases or inflammatory conditions. The test is performed by a lab analyst using fluorescent methods to detect the antigen-antibody reaction in the patient’s sample.

5. When to use CPT code 86255

CPT code 86255 should be used when a lab analyst performs a fluorescent screening test for antibodies to a noninfectious agent in a patient’s blood sample. This code is appropriate for qualitative results, indicating whether the antibodies are present or absent. If a titer is required, CPT code 86256 should be used instead.

6. Documentation requirements

To support a claim for CPT 86255, the documentation should include:

• Indication of the specific noninfectious agent being screened for
• Details of the fluorescent method used for the screening
• Date of the test
• Results of the screening, indicating whether the antibodies are present or absent
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86255, ensure that the test is performed by a lab analyst using a fluorescent method to screen the patient’s blood for antibodies to a noninfectious agent. This code should not be reported with other codes unless specifically required by the payer. It is important to follow payer-specific guidelines and include any necessary modifiers or additional documentation to support the claim.

8. Historical information

CPT 86255 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 performs a fluorescent screening test on a patient’s blood sample to detect the presence of smooth muscle antibodies, indicating liver disease.
2. Using a fluorescent method, a lab analyst screens a patient’s blood for antineutrophilic cytoplasmic antibodies (ANCA), indicating autoimmune vasculitis.
3. A patient’s blood sample is screened for endomysial antibodies using a fluorescent method to diagnose celiac disease, an intestinal inflammatory condition.
4. A lab analyst performs a fluorescent screening test on a patient’s blood sample to detect the presence of antibodies associated with an autoimmune disease.
5. Using a fluorescent method, a lab analyst screens a patient’s blood for antibodies to a noninfectious agent to aid in the diagnosis of a specific condition.
6. A patient’s blood sample is screened for the presence of antibodies to a noninfectious agent using a fluorescent method to assist in the diagnosis of an inflammatory condition.
7. A lab analyst performs a fluorescent screening test on a patient’s blood sample to detect the presence of antibodies associated with an autoimmune disease.
8. Using a fluorescent method, a lab analyst screens a patient’s blood for antibodies to a noninfectious agent to aid in the diagnosis of a specific condition.
9. A patient’s blood sample is screened for the presence of antibodies to a noninfectious agent using a fluorescent method to assist in the diagnosis of an inflammatory condition.
10. A lab analyst performs a fluorescent screening test on a patient’s blood sample to detect the presence of antibodies associated with an autoimmune disease.