How To Use CPT Code 86638

CPT 86638 describes the process of evaluating a patient’s blood for antibodies to the bacterium Coxiella burnetii. 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 86638?

CPT 86638 can be used to describe the laboratory procedure performed to evaluate a patient’s blood for antibodies to the bacterium Coxiella burnetii, which is responsible for Q fever. This code is used when the lab analyst performs an immunoassay, such as an indirect immunofluorescence test or enzyme immunoassay, to detect the presence or absence of Coxiella burnetii antibodies in the patient’s serum.

2. Official Description

The official description of CPT code 86638 is: ‘Antibody; Coxiella burnetii (Q fever).’ This code represents the laboratory analysis of a patient’s blood to determine the presence or absence of antibodies to the bacterium Coxiella burnetii.

3. Procedure

1. The lab analyst collects a blood sample from the patient through venipuncture.
2. The collected blood sample is then subjected to an immunoassay, such as an indirect immunofluorescence test, enzyme immunoassay, or complement fixation test.
3. The immunoassay involves various steps, such as mixing the patient’s serum with a substrate containing Coxiella burnetii antigens, incubating the mixture, and detecting the presence or absence of antibodies through fluorescence, staining, or other markers.
4. The lab analyst evaluates the results of the immunoassay to determine if the patient’s blood contains antibodies to Coxiella burnetii.
5. The presence or absence of antibodies helps in the diagnosis of Q fever and distinguishing between acute and chronic infection.

4. Qualifying circumstances

CPT 86638 is used when a patient’s blood is tested for antibodies to Coxiella burnetii. This test is commonly ordered by clinicians to aid in the diagnosis of Q fever, a condition caused by inhaling material infected with Coxiella burnetii. The test can help differentiate between acute and chronic infection based on the relative levels of IgG and IgM antibodies. The test is performed by a lab analyst using immunoassay techniques, such as indirect immunofluorescence, enzyme immunoassay, or complement fixation test.

5. When to use CPT code 86638

CPT code 86638 should be used when a patient’s blood is tested for antibodies to Coxiella burnetii using an immunoassay technique. This code is appropriate when the test is performed to aid in the diagnosis of Q fever or to monitor the progression of the disease. 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 86638, the documentation should include:

• Reason for ordering the test, such as suspected Q fever
• Details of the immunoassay technique used
• Date of the test
• Results of the test, indicating the presence or absence of Coxiella burnetii antibodies
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86638, ensure that the test is performed using an immunoassay technique to detect Coxiella burnetii antibodies. It is important to report one unit of this code for each immunoglobulin class tested, such as IgG or IgM. If multiple units are performed, appropriate modifiers should be used to indicate that the tests are distinct. It is also important to follow payer-specific guidelines for reporting specimen collection separately, if applicable.

8. Historical information

CPT 86638 was added to the Current Procedural Terminology system on January 1, 1993, with a code change on January 1, 2004. There have been no further updates to the code since then.

9. Examples

1. A lab analyst performs an immunoassay to evaluate a patient’s blood for antibodies to Coxiella burnetii, aiding in the diagnosis of Q fever.
2. A clinician orders a test to monitor the progression of Q fever in a patient, and the lab analyst performs an immunoassay to detect Coxiella burnetii antibodies.
3. A patient with flu-like symptoms undergoes a test to determine if they have been infected with Coxiella burnetii, and the lab analyst performs an immunoassay to detect the presence of antibodies.
4. A patient with a history of exposure to sheep or goats undergoes a test to rule out Q fever, and the lab analyst performs an immunoassay to detect Coxiella burnetii antibodies.
5. A patient with suspected chronic Q fever undergoes a test to assess the levels of IgG and IgM antibodies to Coxiella burnetii, and the lab analyst performs an immunoassay to determine the relative levels of these antibodies.