How To Use CPT Code 86353

CPT 86353 describes the procedure for lymphocyte transformation, specifically mitogen or antigen induced blastogenesis. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 86353?

CPT 86353 can be used to evaluate the T cells of patients with immunodeficiency. This code represents the procedure of lymphocyte transformation, specifically mitogen or antigen induced blastogenesis. It is performed by a lab analyst to test the patient’s T cells using methods such as flow cytometry. The test involves various steps, including the preparation of dye, staining of cells, washing, resuspending, and protecting them from light.

2. Official Description

The official description of CPT code 86353 is: ‘Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis.’

3. Procedure

1. The lab analyst performs the technical steps to test the patient’s T cells using a method such as flow cytometry.
2. A sample, typically blood, is collected from the patient.
3. The cells in the sample are stained with a dye and incubated for 30 minutes.
4. The stained cells are washed and resuspended.
5. The cells are protected from light to prevent any interference.

4. Qualifying circumstances

CPT 86353 is ordered by providers to evaluate T cells in patients with immune deficiencies. It helps assess the functional antigen or mitogen response of T cells. A decrease in T cells can indicate reduced immune function. Lymphocytic blastogenesis refers to the transformation of lymphocytes into larger or less differentiated cells when cultured with a sensitizing antigen. This phenomenon is observed in various immunological states.

5. When to use CPT code 86353

CPT code 86353 should be used when evaluating T cells in patients with immunodeficiency or suspected immune deficiencies. It is not limited to testing for specific conditions but is ordered to assess the functional response of T cells to antigens or mitogens.

6. Documentation requirements

To support a claim for CPT 86353, the documentation should include:

• Reason for ordering the test, such as suspected immune deficiency
• Details of the procedure performed, including the method used (e.g., flow cytometry)
• Date and time of the procedure
• Results of the test, including any quantitative measurements or observations
• Signature of the lab analyst performing the procedure

7. Billing guidelines

When billing for CPT 86353, ensure that the procedure is performed by a qualified lab analyst. It is important to follow the specific guidelines provided by the payer regarding documentation and coding requirements. It is also essential to consider any additional codes that may need to be reported in conjunction with CPT 86353, such as code 36415 for specimen collection.

8. Historical information

CPT 86353 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 performing lymphocyte transformation to evaluate T cells in a patient with suspected immunodeficiency.
2. An immunologist ordering CPT 86353 to assess the functional response of T cells in a patient with recurrent infections.
3. A hematologist using CPT 86353 to evaluate the immune function of T cells in a patient undergoing chemotherapy.
4. A rheumatologist ordering the procedure to assess the T cell response in a patient with suspected autoimmune disease.
5. A pediatrician utilizing CPT 86353 to evaluate the T cell function in a child with recurrent respiratory infections.
6. An allergist performing the procedure to assess the immune response of T cells in a patient with suspected allergies.
7. A hematopathologist ordering CPT 86353 to evaluate the T cell function in a patient with a history of lymphoma.
8. An infectious disease specialist utilizing the procedure to assess the immune response of T cells in a patient with suspected viral infection.
9. A transplant surgeon ordering CPT 86353 to evaluate the T cell function in a patient undergoing organ transplantation.
10. A clinical researcher utilizing the procedure to study the T cell response in patients with various immunological disorders.