How To Use CPT Code 86702

CPT 86702 describes the procedure for evaluating a patient’s serum for antibodies to HIV 2, the human immunodeficiency virus 2. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 86702?

CPT 86702 can be used to evaluate a patient’s serum for antibodies to HIV 2, which is the virus that causes AIDS, or acquired immunodeficiency syndrome. This code is used when a lab analyst performs an immunoassay to test the patient’s serum for the presence of these antibodies. The test may involve various steps, such as reacting the 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 86702 is: ‘Antibody; HIV-2.’

3. Procedure

1. The lab analyst performs an immunoassay to evaluate the patient’s serum for antibodies to HIV 2.
2. The test may include various steps such as reacting the specimen with test antigens, incubating the mixture, adding an agent to detect the antigen-antibody complex, and interpreting the results.
3. The results are reported as positive, negative, or as a semiquantitative value.

4. Qualifying circumstances

CPT 86702 is used to diagnose or rule out possible infection with HIV 2. Clinicians may order this test for patients at high risk, such as those who engage in IV drug use or those presenting with symptoms such as weight loss, recurrent fever or illness, or swollen lymph nodes.

5. When to use CPT code 86702

CPT code 86702 should be used when a clinician orders an antibody test to evaluate a patient’s serum for antibodies to HIV 2. It is important to note that this code is specifically for an antibody test and should not be used for an antigen test for the same organism.

6. Documentation requirements

To support a claim for CPT 86702, the documentation should include:

• Reason for ordering the test, such as symptoms or high-risk factors
• Details of the immunoassay method used
• Date of the test
• Results of the test, reported as positive, negative, or semiquantitative value

7. Billing guidelines

When billing for CPT 86702, ensure that the test is performed by a lab analyst using an immunoassay method. It is important to note that some payers may pay separately for collecting the specimen using a different code, such as 36415. It is also important to review payer-specific guidelines for any additional requirements or modifiers that may be necessary for accurate billing.

8. Historical information

CPT 86702 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 clinician orders CPT 86702 to evaluate a patient’s serum for antibodies to HIV 2 due to symptoms of weight loss and recurrent fever.
2. A patient with a history of IV drug use undergoes CPT 86702 to rule out possible infection with HIV 2.
3. A clinician orders CPT 86702 for a patient presenting with swollen lymph nodes and recurrent illness.
4. A patient with a known exposure to HIV 2 undergoes CPT 86702 to determine if infection has occurred.
5. A clinician orders CPT 86702 as part of routine screening for HIV 2 in a high-risk population.
6. Provide four more examples of cases in which CPT code 86702 should be billed. Only explain the examples and make them all original.