How To Use CPT Code 86617

CPT 86617 describes the confirmatory test for Lyme disease using an immunoassay to evaluate the patient’s blood for antibodies to the bacteria Borrelia burgdorferi. 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 86617?

CPT 86617 can be used to describe the confirmatory test for Lyme disease. This test is performed using an immunoassay to evaluate the patient’s blood for antibodies to the bacteria Borrelia burgdorferi. It is used as a follow-up test after an initial positive test result to confirm the presence of antibodies.

2. Official Description

The official description of CPT code 86617 is: ‘Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot).’ This code is used to report the confirmatory test for Lyme disease, which involves testing the patient’s serum for antibodies using procedures such as Western Blot or immunoblot technique.

3. Procedure

1. The lab analyst performs an immunoassay to evaluate the patient’s blood for antibodies to Borrelia burgdorferi following an initial positive test.
2. The confirmatory test uses procedures such as Western Blot or immunoblot technique.
3. The test may include various steps such as reacting the specimen with multiple test antigens arrayed on a substrate, then adding enzyme-labeled anti-IgG or anti-IgM to allow visualization of bands or blots on the substrate indicating different Borrelia burgdorferi antibodies present in the specimen.

4. Qualifying circumstances

CPT 86617 is used as a confirmatory test for Lyme disease. It is ordered by clinicians as a follow-up test after an initial positive test result. The test helps in the differential diagnosis of Lyme disease and its stage by identifying specific proteins to which the patient has formed antibodies. It can be used to assess the number and intensity of IgG or IgM antibodies present in the patient’s blood.

5. When to use CPT code 86617

CPT code 86617 should be used when performing a confirmatory test for Lyme disease using an immunoassay to evaluate the patient’s blood for antibodies to Borrelia burgdorferi. It is appropriate to use this code as a follow-up test after an initial positive test result to confirm the presence of antibodies.

6. Documentation requirements

To support a claim for CPT 86617, the following documentation is required:

• Indication of the need for a confirmatory test for Lyme disease
• Details of the immunoassay procedure used, such as Western Blot or immunoblot technique
• Date and time of the test
• Results of the test, including the presence or absence of specific Borrelia burgdorferi antibodies
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86617, ensure that the test is performed as a confirmatory test for Lyme disease using an immunoassay. It should be reported as a separate service and not bundled with other tests. If multiple units of this code are performed, appropriate modifiers should be used to indicate that the tests are distinct.

8. Historical information

CPT 86617 was added to the Current Procedural Terminology system on January 1, 1995. There have been no updates to the code since its addition.

9. Examples

1. A patient with a positive initial test for Lyme disease undergoes a confirmatory test using an immunoassay to evaluate the presence of Borrelia burgdorferi antibodies.
2. A clinician orders a confirmatory test for Lyme disease for a patient with symptoms consistent with the disease and a previous positive test result.
3. A lab analyst performs a Western Blot test to confirm the presence of specific Borrelia burgdorferi antibodies in a patient’s blood.
4. A patient with a history of tick exposure and clinical manifestations of Lyme disease undergoes a confirmatory test to aid in the diagnosis and staging of the disease.
5. A clinician orders a confirmatory test for Lyme disease to rule out false-positive results from an initial screening test.