How To Use CPT Code 86413

CPT 86413 describes the quantitative measurement of antibodies to the SARS-CoV-2 virus, which causes COVID-19. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 86413?

CPT 86413 can be used to quantify the level of antibodies to the SARS-CoV-2 virus in a patient’s specimen, such as blood. This code is specifically for a quantitative antibody assay, providing a numerical value to indicate the amount of antibodies present in the patient’s sample.

2. Official Description

The official description of CPT code 86413 is: ‘Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) antibody, quantitative.’

3. Procedure

1. The lab analyst performs an immunoassay to quantify the level of antibodies to the SARS-CoV-2 virus in the patient’s specimen, such as blood.
2. The test may include various steps, such as reacting the specimen with test antigens, incubating the mixture, adding an agent to detect the antigen-antibody complex, and interpreting the results as a quantitative value.

4. Qualifying circumstances

CPT 86413 is typically ordered by clinicians to evaluate a patient for antibodies to the SARS-CoV-2 virus, indicating past infection with COVID-19. It is not limited to testing for specific conditions and can be used for any patient requiring quantitative measurement of SARS-CoV-2 antibodies. The test is performed on a patient’s blood or serum sample.

5. When to use CPT code 86413

CPT code 86413 should be used when a clinician wants to quantify the level of antibodies to the SARS-CoV-2 virus in a patient’s specimen. This code is specifically for a quantitative antibody assay and should be reported when a numerical value is provided to indicate the amount of antibodies present in the patient’s sample.

6. Documentation requirements

To support a claim for CPT 86413, the documentation should include:

• Patient’s specimen type (blood or serum)
• Specific immunoassay method used, such as enzyme-linked immunosorbent assay (ELISA)
• Procedure details, including the steps performed to quantify the antibodies
• Interpretation of the results as a quantitative value

7. Billing guidelines

When billing for CPT 86413, ensure that the test is performed to quantify the level of antibodies to the SARS-CoV-2 virus. It is important to use the correct code for the type of assay performed (quantitative, qualitative, or semiquantitative). Additionally, consider any specific payer requirements or guidelines for reporting this code.

8. Historical information

CPT 86413 was added to the Current Procedural Terminology system on September 8, 2020. There have been no updates to the code since its addition.

9. Examples

1. A patient’s blood sample is tested using CPT 86413 to determine the quantitative level of antibodies to the SARS-CoV-2 virus.
2. A clinician orders CPT 86413 to assess the amount of antibodies present in a patient’s serum sample, indicating past infection with COVID-19.
3. A laboratory performs a quantitative antibody assay using CPT 86413 on a blood specimen to measure the level of antibodies to the SARS-CoV-2 virus.
4. CPT 86413 is used to provide a numerical value indicating the amount of antibodies to the SARS-CoV-2 virus in a patient’s blood sample.
5. A patient’s serum sample is tested using CPT 86413 to quantify the level of antibodies to the SARS-CoV-2 virus, aiding in the evaluation of past infection with COVID-19.
6. A clinician orders CPT 86413 to assess the patient’s immune response to the SARS-CoV-2 virus by quantifying the antibodies present in their blood sample.
7. A laboratory performs a quantitative antibody assay using CPT 86413 on a serum specimen to measure the level of antibodies to the SARS-CoV-2 virus, providing valuable information about the patient’s immune status.
8. CPT 86413 is used to determine the amount of antibodies to the SARS-CoV-2 virus in a patient’s blood sample, aiding in the diagnosis and management of COVID-19.
9. A patient’s serum sample is tested using CPT 86413 to quantify the level of antibodies to the SARS-CoV-2 virus, helping to assess their immune response and potential immunity to COVID-19.
10. A clinician orders CPT 86413 to evaluate the patient’s antibody levels to the SARS-CoV-2 virus, providing valuable information about their past exposure and potential immunity to COVID-19.