How To Use CPT Code 86665

CPT 86665 describes the immunoassay procedure used to evaluate a patient’s serum for antibodies to viral capsid antigen (VCA) of the Epstein-Barr virus (EBV). This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 86665?

CPT 86665 can be used to describe the immunoassay procedure performed by a lab analyst to evaluate a patient’s serum for antibodies to the viral capsid antigen (VCA) of the Epstein-Barr virus (EBV). This code is used when the lab analyst performs the technical steps to test the patient’s serum using immunoassay methods such as enzyme immunoassay (EIA) or multiplex flow immunoassay.

2. Official Description

The official description of CPT code 86665 is: ‘Antibody; Epstein-Barr (EB) virus, viral capsid (VCA).’ This code is used to report the immunoassay procedure that detects antibodies to EBV VCA in the patient’s serum.

3. Procedure

1. The lab analyst collects the patient’s serum sample.
2. The lab analyst performs an immunoassay using methods such as EIA or multiplex flow immunoassay.
3. The immunoassay involves 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 are reported as positive, negative, or as a semi-quantitative value.

4. Qualifying circumstances

CPT 86665 is used when clinicians order the immunoassay to aid in the diagnosis of an EBV infection. This test can be helpful in diagnosing conditions such as infectious mononucleosis, especially when the patient is symptomatic but has a negative mono screening test for heterophile antibodies. It can also be used for symptomatic pregnant women as part of a larger panel to distinguish EBV infection from other similar conditions. Additionally, the test may be ordered to establish prior EBV infection in immunocompromised patients.

5. When to use CPT code 86665

CPT code 86665 should be used when performing a multi-step qualitative or semi-quantitative immunoassay to detect antibodies to EBV VCA. 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 86665, documentation should include:

• Reason for ordering the test, such as suspected EBV infection or to establish prior infection
• Details of the immunoassay method used, such as EIA or multiplex flow immunoassay
• Date of the test
• Results of the test, reported as positive, negative, or semi-quantitative value

7. Billing guidelines

When billing for CPT 86665, it is important to use the correct code for the immunoassay procedure. If the specimen collection is separately billed, a separate code such as 36415 for venipuncture may be used. It is also important to report one unit of CPT 86665 for each EBV VCA immunoglobulin class tested, such as IgG or IgM. If multiple units are performed, modifiers may be used to indicate that the tests are distinct.

8. Historical information

CPT 86665 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 serum for antibodies to EBV VCA, and the results are reported as positive for IgG.
2. As part of a larger panel, a clinician orders an immunoassay to distinguish EBV infection from other similar conditions in a symptomatic pregnant woman, and the results are reported as negative for IgM.
3. An immunocompromised patient undergoes an immunoassay to establish prior EBV infection, and the results are reported as positive for both IgG and IgM.
4. A patient with symptoms of infectious mononucleosis undergoes an immunoassay to confirm the diagnosis, and the results are reported as positive for IgM.
5. A clinician orders an immunoassay to evaluate a patient with suspected EBV infection, and the results are reported as negative for both IgG and IgM.