How To Use CPT Code 86336

CPT 86336 describes the test performed to identify the levels of inhibin A in a pregnant patient’s serum, specifically to determine the risk for Down syndrome in the fetus. 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 86336?

CPT 86336 can be used to describe the test performed by a lab analyst to identify the levels of inhibin A in a pregnant patient’s serum. This test is specifically done to determine the risk for Down syndrome in the fetus. The lab analyst collects a blood specimen through routine vein puncture and performs the necessary technical steps to test the patient’s serum for inhibin A.

2. Official Description

The official description of CPT code 86336 is: ‘Inhibin A; maternal serum, quantitative.’

3. Procedure

1. The lab analyst collects a blood specimen from the patient through routine vein puncture.
2. The blood specimen is centrifuged to separate the serum from the cellular components.
3. The lab analyst performs a screening test known as the maternal serum quadruple screening test, which includes four markers: Alpha fetoprotein (AFP), human chorionic gonadotropin (HCG), estriol, and inhibin A.
4. The lab analyst uses a methodology such as radioimmunoassay (RIA) to measure the levels of inhibin A in the patient’s serum.
5. The lab analyst compares the analyte values to the median values at the given gestational age and obtains multiples of the median (MoM) to determine the risk factors for Down syndrome in the fetus.

4. Qualifying circumstances

CPT 86336 is used for pregnant patients who require testing to determine the risk for Down syndrome in the fetus. The test specifically measures the levels of inhibin A in the patient’s serum. Inhibin A is a hormone produced by the sex glands and its levels can indicate the presence of Down syndrome in the fetus. The test is typically performed between 15 to 21 weeks of pregnancy.

5. When to use CPT code 86336

CPT code 86336 should be used when a lab analyst performs a quantitative test to measure the levels of inhibin A in a pregnant patient’s serum. This test is specifically done to determine the risk for Down syndrome in the fetus. It is important to use this code when reporting the test results accurately.

6. Documentation requirements

To support a claim for CPT 86336, the following documentation is required:

• Patient’s pregnancy status and gestational age
• Specific test performed to measure inhibin A levels
• Date and time of the test
• Results of the test, including the levels of inhibin A
• Comparison of analyte values to median values at the given gestational age
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86336, ensure that the test is performed by a lab analyst and that the documentation requirements are met. It is important to accurately report the test results and any additional information required by the payer. Some payers may also separately reimburse for the collection of the blood specimen, which can be reported with code 36415.

8. Historical information

CPT 86336 was added to the Current Procedural Terminology system on January 1, 2002. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performing a quantitative test to measure the levels of inhibin A in a pregnant patient’s serum to determine the risk for Down syndrome in the fetus.
2. A pregnant patient undergoing the maternal serum quadruple screening test, which includes the measurement of inhibin A levels, to assess the risk for Down syndrome in the fetus.
3. A lab analyst comparing the analyte values of inhibin A in a pregnant patient’s serum to the median values at the given gestational age to determine the risk factors for Down syndrome in the fetus.
4. A pregnant patient receiving the test for inhibin A levels in her serum to assess the risk for Down syndrome in the fetus at 18 weeks of pregnancy.
5. A lab analyst using radioimmunoassay to measure the levels of inhibin A in a pregnant patient’s serum and obtaining multiples of the median to determine the risk factors for Down syndrome in the fetus.
6. A pregnant patient undergoing the inhibin A test as part of the maternal serum quadruple screening test to evaluate the risk for Down syndrome in the fetus.
7. A lab analyst performing the quantitative test for inhibin A levels in a pregnant patient’s serum and comparing the results to the median values at the given gestational age to assess the risk for Down syndrome in the fetus.
8. A pregnant patient receiving the inhibin A test to determine the risk for Down syndrome in the fetus, with the lab analyst performing the necessary steps to measure the levels of inhibin A in the patient’s serum.
9. A lab analyst using a screening test to measure the levels of inhibin A in a pregnant patient’s serum and obtaining multiples of the median to assess the risk factors for Down syndrome in the fetus.
10. A pregnant patient undergoing the test for inhibin A levels in her serum, with the lab analyst performing the necessary technical steps to measure the levels and determine the risk for Down syndrome in the fetus.