How To Use CPT Code 86308

CPT 86308 describes the screening for heterophile antibodies using an immunoassay 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 86308?

CPT 86308 can be used to describe the screening for heterophile antibodies in a patient’s serum or plasma. This code is used when a lab analyst performs an immunoassay to test for the presence of heterophile antibodies, which are typically found in infectious mononucleosis (mono).

2. Official Description

The official description of CPT code 86308 is: ‘Heterophile antibodies; screening.’

3. Procedure

1. The lab analyst collects a sample of the patient’s serum or plasma.
2. The analyst performs an immunoassay using a method such as latex agglutination to screen for heterophile antibodies.
3. The test may involve combining the sample with antigen-coated latex particles, rotating the test platform, and observing for agglutination of the antigen-antibody complexes.
4. The analyst reports the qualitative results as either positive or negative for heterophile antibodies.

4. Qualifying circumstances

CPT 86308 is used when a patient is suspected of having infectious mononucleosis or another condition that produces heterophile antibodies. This test helps diagnose patients, particularly children and adolescents, who present with symptoms such as fever, lymphadenopathy (enlarged lymph nodes), and fatigue. The test may also be ordered for patients with serum sickness, an allergic reaction to certain drugs or antiserum injections.

5. When to use CPT code 86308

CPT code 86308 should be used when a lab analyst performs a screening test for heterophile antibodies using an immunoassay method. It is appropriate to bill this code when the test is ordered to help diagnose patients with symptoms suggestive of infectious mononucleosis or other conditions that produce heterophile antibodies.

6. Documentation requirements

To support a claim for CPT 86308, the following documentation is required:

• Indication for the test, such as symptoms suggestive of infectious mononucleosis or another condition producing heterophile antibodies
• Details of the immunoassay method used, such as latex agglutination
• Date of the test
• Qualitative results of the test (positive or negative for heterophile antibodies)

7. Billing guidelines

When billing for CPT 86308, ensure that the test is performed by a lab analyst using an immunoassay method. This code should not be reported with codes 86602-86804, which are used for antibodies to specific infectious agents. It is important to note that some payers may separately reimburse for specimen collection using a code such as 36415, which represents venous blood collection by venipuncture.

8. Historical information

CPT 86308 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 performs an immunoassay to screen a patient’s serum for heterophile antibodies, which are indicative of infectious mononucleosis.
2. A clinician orders a heterophile antibody screening test for a child with fever, lymphadenopathy, and fatigue to help diagnose the presence of infectious mononucleosis.
3. A patient presents with symptoms suggestive of serum sickness after receiving antiserum injections, and a heterophile antibody screening test is performed to confirm the diagnosis.
4. A lab analyst uses an immunoassay method to screen a patient’s plasma for heterophile antibodies, which may indicate the presence of an allergic reaction to certain drugs.
5. A clinician orders a heterophile antibody screening test for a patient with symptoms of mono, such as fever and fatigue, to aid in the diagnosis of infectious mononucleosis.