How To Use CPT Code 86720

CPT 86720 describes the evaluation of a patient’s serum for antibodies to Leptospira, a spirochete bacteria. 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 86720?

CPT 86720 can be used to evaluate a patient’s serum for antibodies to Leptospira, a type of spiral-shaped bacteria. This test is performed using an immunoassay method, such as enzyme-linked immunosorbent assay (ELISA), to detect the presence of antibodies in the patient’s blood. The results of this test can help diagnose Leptospira infection, which can cause flu-like symptoms and potentially lead to severe complications if left untreated.

2. Official Description

The official description of CPT code 86720 is: ‘Antibody; Leptospira.’

3. Procedure

1. The lab analyst collects a sample of the patient’s serum.
2. The lab analyst performs an immunoassay, such as ELISA, to test the patient’s serum for antibodies to Leptospira.
3. The test may involve reacting the specimen with test antigens, incubating the mixture, and adding an agent to detect the antigen-antibody complex.
4. The lab analyst interprets the results of the test as positive, negative, or as a semiquantitative value.

4. Qualifying circumstances

CPT 86720 is typically ordered for patients who present with symptoms such as flu-like illness, headache, abdominal pain, vomiting, red eyes, or muscle pain that does not improve with symptomatic treatment. This test is used to detect antibodies to Leptospira in the patient’s serum, indicating a possible infection. It is important to note that this code should not be used for antigen detection.

5. When to use CPT code 86720

CPT code 86720 should be used when a healthcare provider orders a test to evaluate a patient’s serum for antibodies to Leptospira. This test is appropriate when there is a clinical suspicion of Leptospira infection based on the patient’s symptoms and exposure history. It is important to follow the specific indications for this test and not use it for other purposes.

6. Documentation requirements

To support a claim for CPT code 86720, the healthcare provider must document the following information:

• Reason for ordering the test, including the patient’s symptoms and exposure history
• Details of the test performed, including the method used (e.g., ELISA)
• Date of the test
• Interpretation of the test results
• Signature of the healthcare provider ordering the test

7. Billing guidelines

When billing for CPT code 86720, ensure that the test is performed to evaluate the patient’s serum for antibodies to Leptospira. It is important to use the appropriate diagnosis code to support medical necessity. Additionally, be aware that some payers may separately reimburse for the collection of the specimen using a different code, such as 36415 for venous blood collection.

8. Historical information

CPT code 86720 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 patient presents with flu-like symptoms and a history of exposure to potentially contaminated urine. The healthcare provider orders CPT code 86720 to evaluate the patient’s serum for antibodies to Leptospira.
2. A patient experiences persistent muscle pain that does not improve with symptomatic treatment. The healthcare provider suspects Leptospira infection and orders CPT code 86720 to test the patient’s serum for antibodies to Leptospira.
3. A patient develops red eyes and abdominal pain after a camping trip. The healthcare provider orders CPT code 86720 to evaluate the patient’s serum for antibodies to Leptospira.
4. A patient presents with headache and vomiting. The healthcare provider suspects Leptospira infection and orders CPT code 86720 to test the patient’s serum for antibodies to Leptospira.
5. A patient experiences respiratory failure and has a history of exposure to potentially contaminated urine. The healthcare provider orders CPT code 86720 to evaluate the patient’s serum for antibodies to Leptospira.
6. A patient presents with flu-like symptoms and a history of exposure to animals. The healthcare provider suspects Leptospira infection and orders CPT code 86720 to test the patient’s serum for antibodies to Leptospira.
7. A patient develops muscle pain and red eyes after swimming in a lake. The healthcare provider orders CPT code 86720 to evaluate the patient’s serum for antibodies to Leptospira.
8. A patient experiences persistent headache and abdominal pain. The healthcare provider suspects Leptospira infection and orders CPT code 86720 to test the patient’s serum for antibodies to Leptospira.
9. A patient presents with flu-like symptoms and a history of exposure to potentially contaminated urine. The healthcare provider orders CPT code 86720 to evaluate the patient’s serum for antibodies to Leptospira.
10. A patient develops muscle pain and red eyes after a hiking trip. The healthcare provider suspects Leptospira infection and orders CPT code 86720 to test the patient’s serum for antibodies to Leptospira.