How To Use CPT Code 86625

CPT 86625 describes the process of performing an immunoassay to evaluate a patient’s blood for antibodies to the bacteria Campylobacter. 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 86625?

CPT 86625 can be used to describe the laboratory procedure of testing a patient’s serum for antibodies to the bacteria Campylobacter. This code is used when the lab analyst performs an immunoassay, such as enzyme-linked immunosorbent assay (ELISA), to detect the presence of Campylobacter antibodies in the patient’s blood.

2. Official Description

The official description of CPT code 86625 is: ‘Antibody; Campylobacter.’

3. Procedure

1. The lab analyst collects a blood sample from the patient.
2. The collected blood sample is then tested using an immunoassay, such as ELISA, to detect the presence of antibodies specific to Campylobacter.
3. The test 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.
4. The results of the test are reported as positive, negative, or as a semi-quantitative value.

4. Qualifying circumstances

CPT 86625 is used when clinicians order the test to aid in the diagnosis of Campylobacter infection. This may be done when a patient presents with symptoms such as fever, diarrhea, stomach cramps, and vomiting, which may indicate exposure to Campylobacter. The test can also be used to monitor the immune response in immune-compromised individuals or to confirm recent or ongoing Campylobacter infection, even if stool culture is negative for the organism.

5. When to use CPT code 86625

CPT code 86625 should be used when performing a multi-step qualitative or semi-quantitative immunoassay to detect Campylobacter antibodies. It should not be used for antigen detection or for single-step methods such as reagent strips. For quantitative tests, a different code should be used.

6. Documentation requirements

To support a claim for CPT 86625, documentation should include:

• Reason for ordering the test, such as suspected Campylobacter infection
• Details of the immunoassay method used, such as ELISA
• Date of the test
• Results of the test, reported as positive, negative, or semi-quantitative value

7. Billing guidelines

When billing for CPT 86625, it is important to ensure that the test is performed using a multi-step qualitative or semi-quantitative immunoassay for Campylobacter antibodies. If multiple units of the code are performed, appropriate modifiers should be used to indicate that the tests are distinct. It is also important to check with the payer regarding any specific requirements or guidelines for reporting this code.

8. Historical information

CPT 86625 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 performing an immunoassay to detect Campylobacter antibodies in a patient’s blood sample.
2. A clinician ordering CPT 86625 to aid in the diagnosis of Campylobacter infection in a patient with symptoms of food poisoning.
3. A patient with a suspected Campylobacter infection undergoing a multi-step immunoassay to confirm the presence of Campylobacter antibodies.
4. An immune-compromised individual being monitored for the immune response to Campylobacter infection using CPT 86625.
5. A patient with a negative stool culture for Campylobacter but suspected ongoing infection undergoing CPT 86625 to confirm the presence of antibodies.