How To Use CPT Code 86692

CPT 86692 describes the immunoassay procedure used to evaluate a patient’s serum for antibodies to hepatitis D, also known as hepatitis delta agent. 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 86692?

CPT 86692 can be used to describe the immunoassay procedure performed by a lab analyst to evaluate a patient’s serum for antibodies to hepatitis D, also known as hepatitis delta agent. This test helps diagnose or rule out possible infection with hepatitis D, a virus that only infects individuals already infected with hepatitis B. The test involves reacting the patient’s specimen with test antigens, incubating the mixture, adding an agent to detect the antigen-antibody complex, and interpreting the results.

2. Official Description

The official description of CPT code 86692 is: ‘Antibody; hepatitis, delta agent.’ This code specifically refers to the immunoassay procedure used to detect antibodies to hepatitis D in a patient’s serum.

3. Procedure

1. The lab analyst collects a serum sample from the patient.
2. The serum sample is tested using an immunoassay method, such as enzyme immunosorbent assay (EIA).
3. The test involves reacting the specimen with test antigens and incubating the mixture.
4. An agent, such as a stain or fluorescent marker, is added to detect the antigen-antibody complex.
5. The lab analyst interprets the results as positive, negative, or as a semiquantitative value.

4. Qualifying circumstances

CPT 86692 is used when clinicians order the test to diagnose or rule out possible infection with hepatitis D. This virus only infects individuals already infected with hepatitis B. The test helps assess the presence of antibodies to hepatitis D in the patient’s serum, indicating a current or past infection. The test is typically ordered for patients who exhibit symptoms of hepatitis, such as jaundice, fever, tiredness, nausea, joint pain, and liver damage.

5. When to use CPT code 86692

CPT code 86692 should be used when a clinician orders the immunoassay procedure to evaluate a patient’s serum for antibodies to hepatitis D. It is appropriate to use this code when there is a clinical suspicion of hepatitis D infection, especially in patients already infected with hepatitis B. This code should not be used for testing other types of antibodies or antigens.

6. Documentation requirements

To support a claim for CPT 86692, the documentation should include:

• Reason for ordering the test, such as suspected hepatitis D infection
• Details of the immunoassay method used, such as enzyme immunosorbent assay (EIA)
• Date of the test
• Results of the test, including whether it was positive, negative, or a semiquantitative value
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86692, ensure that the immunoassay procedure is performed to evaluate a patient’s serum for antibodies to hepatitis D. This code should not be reported with other codes for different organisms or antigens. Some payers may separately reimburse for specimen collection using a code such as 36415.

8. Historical information

CPT 86692 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 evaluate a patient’s serum for antibodies to hepatitis D.
2. A clinician ordering CPT 86692 to diagnose or rule out possible infection with hepatitis D in a patient already infected with hepatitis B.
3. A patient exhibiting symptoms of hepatitis, such as jaundice and fatigue, undergoing the immunoassay procedure to assess the presence of antibodies to hepatitis D.
4. A lab analyst interpreting the results of the immunoassay as positive for antibodies to hepatitis D in a patient’s serum.
5. A clinician using CPT 86692 to monitor the effectiveness of treatment for hepatitis D in a patient already infected with hepatitis B.