How To Use CPT Code 86711

CPT 86711 describes the immunoassay procedure used to evaluate a patient’s serum for antibodies to the John Cunningham virus (JCV). 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 86711?

CPT 86711 can be used to describe the immunoassay procedure performed by a lab analyst to test a patient’s serum for antibodies to the John Cunningham virus (JCV). This code is used when the analyst uses an immunoassay method, such as enzyme-linked immunosorbent assay (ELISA), to detect the presence of JCV antibodies in the patient’s serum.

2. Official Description

The official description of CPT code 86711 is: ‘Antibody; JC (John Cunningham) virus.’

3. Procedure

1. The lab analyst collects a serum sample from the patient.
2. The analyst performs an immunoassay using an ELISA method to test the patient’s serum for antibodies to the JCV.
3. The immunoassay may involve multiple 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.
4. The results of the immunoassay are reported as positive, negative, or as a semi-quantitative value.

4. Qualifying circumstances

CPT 86711 is typically ordered by clinicians to help indicate the course of disease progression and treatment options for patients with progressive multifocal leukoencephalopathy (PML). The presence of JCV antibodies in immunocompromised patients or those taking certain immunosuppressive medications is a risk factor for PML. The test is not limited to specific conditions and can be ordered based on clinical judgment.

5. When to use CPT code 86711

CPT code 86711 should be used when a lab analyst performs an immunoassay to evaluate a patient’s serum for antibodies to the JCV. This code is appropriate for qualitative or semi-quantitative immunoassays and should not be used for antigen detection. If a single-step method or a quantitative test is performed, different codes should be reported.

6. Documentation requirements

To support a claim for CPT 86711, the documentation should include:

• Indication for the test and its relevance to the patient’s condition
• 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 86711, ensure that the immunoassay is performed to detect JCV antibodies using a multi-step qualitative or semi-quantitative method. If multiple units of this code are performed, check with the payer for any modifier requirements to indicate that the tests are distinct. It is important to note that this code should not be reported for antigen detection.

8. Historical information

CPT 86711 was added to the Current Procedural Terminology system on January 1, 2013. 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 JCV antibodies, and the results are reported as positive.
2. A clinician orders an immunoassay to test a patient’s serum for JCV antibodies to assess the risk of progressive multifocal leukoencephalopathy.
3. A patient with an immunocompromised condition undergoes an immunoassay to detect JCV antibodies as part of their disease management.
4. A lab analyst performs an immunoassay to evaluate a patient’s serum for JCV antibodies, and the results are reported as negative.
5. A clinician orders an immunoassay to test a patient’s serum for JCV antibodies to rule out the risk of progressive multifocal leukoencephalopathy.
6. A patient taking immunosuppressive medications undergoes an immunoassay to detect JCV antibodies as a precautionary measure.
7. A lab analyst performs an immunoassay to evaluate a patient’s serum for JCV antibodies, and the results are reported as a semi-quantitative value.
8. A clinician orders an immunoassay to test a patient’s serum for JCV antibodies to monitor the progression of their disease.
9. A patient with a history of JCV infection undergoes an immunoassay to detect JCV antibodies as part of their follow-up care.
10. A lab analyst performs an immunoassay to evaluate a patient’s serum for JCV antibodies, and the results are inconclusive.