How To Use CPT Code 86352

CPT 86352 describes the cellular function assay involving stimulation and detection of a biomarker to assess immune system suppression. 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 86352?

CPT 86352 can be used to describe a cellular function assay that measures immune system suppression. This test involves stimulating cell function with an antigen or mitogen and detecting the biomarker adenosine triphosphate (ATP). It helps in the treatment of patients at increased risk for infection and reduces the risk of rejection during organ transplantation.

2. Official Description

The official description of CPT code 86352 is: ‘Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP).’

3. Procedure

1. The lab analyst performs a cellular function assay to assess immune system suppression.
2. The assay involves stimulating cell function with an antigen or mitogen.
3. After 15 to 18 hours of incubation, the concentration of ATP released by CD4 cells is measured.
4. The test is qualitative and detects cell-mediated immunity in whole blood.

4. Qualifying circumstances

CPT 86352 is ordered to assess immune system suppression that increases the risk for infection or rejection in organ transplantation. It is not limited to testing for specific conditions and can be used for patients at increased risk for infection or rejection.

5. When to use CPT code 86352

CPT code 86352 should be used when a cellular function assay is performed to assess immune system suppression. It is appropriate when there is a need to monitor immune system function and determine the risk of infection or rejection in organ transplantation.

6. Documentation requirements

To support a claim for CPT 86352, the documentation should include:

• Reason for ordering the test and the need to assess immune system suppression
• Details of the cellular function assay performed, including the stimulation method and biomarker detection
• Date and time of the test
• Results of the assay, including the concentration of ATP released by CD4 cells
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86352, ensure that the cellular function assay involves stimulation and detection of a biomarker. It should be reported separately from other services, and any additional specimen collection should be reported with the appropriate code, such as 36415 for venous blood collection.

8. Historical information

CPT 86352 was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates to the code since its addition.

9. Examples

1. A cellular function assay is performed to assess immune system suppression in a patient undergoing organ transplantation.
2. A patient with a compromised immune system undergoes a cellular function assay to monitor their immune system function and risk of infection.
3. A physician orders a cellular function assay to assess immune system suppression in a patient with a history of recurrent infections.
4. A cellular function assay is performed to evaluate the effectiveness of immunosuppressive therapy in a patient with an autoimmune disease.
5. A patient with a suspected immune system disorder undergoes a cellular function assay to determine the cause of their symptoms.
6. A cellular function assay is performed as part of a pre-transplant evaluation to assess the patient’s immune system function and risk of rejection.
7. A patient with a history of organ rejection undergoes a cellular function assay to monitor their immune system function and risk of rejection.
8. A physician orders a cellular function assay to assess immune system suppression in a patient receiving long-term immunosuppressive therapy.
9. A cellular function assay is performed to evaluate the immune system function in a patient with a suspected immunodeficiency disorder.
10. A patient with a history of recurrent infections undergoes a cellular function assay to assess their immune system function and risk of infection.