How To Use CPT Code 86318

CPT 86318 describes the use of a single-step immunoassay to qualitatively or semiquantitatively evaluate a patient’s specimen for antibodies to an unspecified infectious agent. 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 86318?

CPT 86318 can be used to evaluate a patient’s specimen, such as blood, for antibodies to an unspecified infectious agent using a single-step immunoassay. This code is used when the lab analyst performs the technical steps to test the patient sample for antibodies to an infectious agent that does not have its own specific code for this method.

2. Official Description

The official description of CPT code 86318 is: ‘Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip).’

3. Procedure

1. The lab analyst performs a single-step immunoassay to qualitatively or semiquantitatively evaluate the patient’s specimen, such as blood, for antibodies to an unspecified infectious agent.
2. The test may use methods such as chromatographic immunoassay that produces a color change when antibodies in whole blood migrate through a reagent test strip containing specific antigens.

4. Qualifying circumstances

CPT 86318 can be used when clinicians order a test to evaluate a patient specimen for antibodies to an infectious agent that does not have its own specific code for this method. The test is not limited to specific conditions and can be used to evaluate a patient’s specimen for antibodies to an unspecified infectious agent.

5. When to use CPT code 86318

CPT code 86318 should be used when a single-step immunoassay is performed to evaluate a patient’s specimen for antibodies to an unspecified infectious agent. This code should not be used if CPT provides a similar code to test for antibodies of a specific organism. For specific infectious agents, refer to the Immunology section for antibody tests using multiple-step immunoassay methods.

6. Documentation requirements

To support a claim for CPT 86318, the documentation should include:

• Patient’s specimen, such as blood, being tested for antibodies to an unspecified infectious agent
• Details of the single-step immunoassay method used
• Results of the qualitative or semiquantitative evaluation

7. Billing guidelines

When billing for CPT 86318, ensure that the test performed is a single-step immunoassay for antibodies to an unspecified infectious agent. This code should not be reported if CPT provides a similar code for testing antibodies of a specific organism. Some payers may also separately reimburse for specimen collection using a different code.

8. Historical information

CPT 86318 was added to the Current Procedural Terminology system on January 1, 1990. The code was later changed on April 10, 2020 to its current description.

9. Examples

1. A lab analyst performs a single-step immunoassay to evaluate a patient’s blood specimen for antibodies to an unspecified infectious agent.
2. A patient’s blood sample is tested using a single-step immunoassay to detect antibodies to an unknown infectious agent.
3. A single-step immunoassay is used to qualitatively evaluate a patient’s specimen for antibodies to an unspecified infectious agent.
4. A reagent strip is employed in a single-step immunoassay to semiquantitatively assess a patient’s blood for antibodies to an unknown infectious agent.
5. A chromatographic immunoassay is performed as a single-step method to detect antibodies to an unspecified infectious agent in a patient’s specimen.