How To Use CPT Code 86756

CPT 86756 describes the evaluation of a patient’s serum for respiratory syncytial virus (RSV) using an immunoassay method. 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 86756?

CPT 86756 can be used to evaluate a patient’s serum for respiratory syncytial virus (RSV) using an immunoassay method. This code is used when a lab analyst performs all the technical steps to test the patient’s serum for antibodies to RSV. 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.

2. Official Description

The official description of CPT code 86756 is: ‘Antibody; respiratory syncytial virus.’

3. Procedure

1. The lab analyst performs an immunoassay to evaluate the patient’s serum for respiratory syncytial virus (RSV).
2. The test may include 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 86756 is typically ordered for patients with respiratory tract infections. Respiratory syncytial virus (RSV) is a common virus that affects the respiratory system and is transmitted through the air. Symptoms of RSV can include cough, stuffy nose, low-grade fever, breathing difficulty, wheezing, and bluish skin color in infants.

5. When to use CPT code 86756

CPT code 86756 should be used when a lab analyst performs an immunoassay to evaluate a patient’s serum for respiratory syncytial virus (RSV). This code is appropriate for testing patients with respiratory tract infections or suspected RSV infection.

6. Documentation requirements

To support a claim for CPT 86756, the documentation should include:

• Reason for ordering the test, such as respiratory tract infection or suspected RSV infection
• Details of the immunoassay method used, such as enzyme-linked immunosorbent assay (ELISA)
• Date of the test
• Results of the test, reported as positive, negative, or semiquantitative value

7. Billing guidelines

When billing for CPT 86756, ensure that the test is performed by a lab analyst using an immunoassay method to evaluate the patient’s serum for respiratory syncytial virus (RSV). There may be separate codes for specimen collection, such as CPT code 36415 for venous blood collection. It is important to follow payer-specific guidelines and include any necessary modifiers.

8. Historical information

CPT 86756 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 respiratory syncytial virus (RSV).
2. A patient with respiratory tract infection undergoes an immunoassay to test for respiratory syncytial virus (RSV).
3. A lab technician uses an immunoassay method to evaluate a patient’s serum for antibodies to respiratory syncytial virus (RSV).
4. A physician orders an immunoassay to test a patient’s serum for respiratory syncytial virus (RSV) due to suspected infection.
5. A child with symptoms of RSV undergoes an immunoassay to confirm the presence of the virus.
6. A lab analyst performs an immunoassay to evaluate a patient’s serum for respiratory syncytial virus (RSV) as part of a diagnostic workup.
7. A patient with a compromised immune system undergoes an immunoassay to test for respiratory syncytial virus (RSV) infection.
8. A physician orders an immunoassay to evaluate a patient’s serum for antibodies to respiratory syncytial virus (RSV) before a surgical procedure.
9. A lab technician performs an immunoassay to test a patient’s serum for respiratory syncytial virus (RSV) as part of a research study.
10. A patient with symptoms of respiratory tract infection undergoes an immunoassay to determine if respiratory syncytial virus (RSV) is the causative agent.