How To Use CPT Code 86612

CPT 86612 describes the immunoassay performed by a lab analyst to evaluate a patient’s blood for antibodies to the fungus Blastomyces. 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 86612?

CPT 86612 can be used to describe the immunoassay performed by a lab analyst to test a patient’s serum for antibodies to the fungus Blastomyces. This code is used when the lab analyst follows specific procedures, such as enzyme immunoassay (EIA), to detect the presence of Blastomyces antibodies in the patient’s blood.

2. Official Description

The official description of CPT code 86612 is: ‘Antibody; Blastomyces.’

3. Procedure

1. The lab analyst collects the patient’s blood sample.
2. The lab analyst performs an immunoassay, such as enzyme immunoassay (EIA), to test the patient’s serum for antibodies to Blastomyces.
3. The immunoassay may involve multiple steps, including reacting the specimen with test antigens, incubating the mixture, adding an agent to detect the antigen/antibody complex, and interpreting the results as positive, negative, or semi-quantitative.
4. The lab analyst interprets the results of the immunoassay and reports them as positive, negative, or as a semi-quantitative value.

4. Qualifying circumstances

CPT 86612 is used when clinicians order the test to aid in the diagnosis of blastomycosis, a condition caused by inhaling spores of the fungus Blastomyces dermatitidis. The test is performed on patients who exhibit symptoms such as a painful cough, blood in the sputum, fever, night sweats, and the development of pus-filled granulomas in the skin, bone, and internal genitalia. The test is performed by a lab analyst using specific immunoassay procedures, such as EIA, to detect the presence of Blastomyces antibodies in the patient’s blood.

5. When to use CPT code 86612

CPT code 86612 should be used when a lab analyst performs an immunoassay to evaluate a patient’s blood for antibodies to the fungus Blastomyces. This code is appropriate when the test is ordered to aid in the diagnosis of blastomycosis and when the lab analyst follows specific procedures, such as EIA, to detect the presence of Blastomyces antibodies.

6. Documentation requirements

To support a claim for CPT 86612, the lab analyst must document the following information:

• Patient’s symptoms and the need for the test
• Specific immunoassay procedure used, such as EIA
• Date of the test
• Results of the test, reported as positive, negative, or semi-quantitative

7. Billing guidelines

When billing for CPT 86612, ensure that the test is performed by a lab analyst using specific immunoassay procedures, such as EIA, to detect Blastomyces antibodies. This code should not be reported for antigen detection. It is important to follow the guidelines provided by payers regarding modifier use and reporting multiple units of this code if necessary.

8. Historical information

CPT 86612 was added to the Current Procedural Terminology system on January 1, 1993. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs an immunoassay to evaluate a patient’s blood for antibodies to Blastomyces, aiding in the diagnosis of blastomycosis.
2. A patient presents with respiratory symptoms, and a lab analyst performs an immunoassay to detect the presence of Blastomyces antibodies in their blood.
3. A lab analyst follows specific immunoassay procedures, such as EIA, to test a patient’s serum for antibodies to Blastomyces, assisting in the diagnosis of blastomycosis.
4. A patient with symptoms of blastomycosis undergoes an immunoassay performed by a lab analyst to detect Blastomyces antibodies in their blood.
5. A lab analyst interprets the results of an immunoassay and reports the presence of Blastomyces antibodies in a patient’s blood, aiding in the diagnosis of blastomycosis.
6. A patient with suspected blastomycosis undergoes an immunoassay performed by a lab analyst, confirming the presence of Blastomyces antibodies in their blood.
7. A lab analyst performs an immunoassay to evaluate a patient’s blood for antibodies to Blastomyces, providing valuable information for the diagnosis of blastomycosis.
8. A patient with symptoms consistent with blastomycosis undergoes an immunoassay performed by a lab analyst, confirming the presence of Blastomyces antibodies in their blood.
9. A lab analyst follows specific immunoassay procedures to test a patient’s serum for antibodies to Blastomyces, aiding in the diagnosis of blastomycosis.
10. A patient with suspected blastomycosis undergoes an immunoassay performed by a lab analyst, detecting the presence of Blastomyces antibodies in their blood.