How To Use CPT Code 86757

CPT 86757 describes the laboratory procedure for evaluating a patient’s serum for antibodies to Rickettsia. 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 86757?

CPT 86757 can be used to describe the laboratory procedure performed by a lab analyst to evaluate a patient’s serum for antibodies to Rickettsia. This test helps in the diagnosis of diseases caused by Rickettsia bacteria, such as typhus, rickettsial pox, and Rocky mountain spotted fever.

2. Official Description

The official description of CPT code 86757 is: ‘Antibody; Rickettsia.’

3. Procedure

1. The lab analyst performs an immunoassay to evaluate the patient’s serum for antibodies to Rickettsia.
2. The immunoassay method used 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. Another method that may be used is indirect fluorescent antibody (IFA), where the analyst adds the patient’s serum samples at various dilutions to test plates or slides containing cells infected by the Rickettsia antigen. The analyst then adds a fluorescent marker joined to a suitable antispecies antibody to observe the slides under a microscope with ultraviolet illumination.

4. Qualifying circumstances

CPT 86757 is used when a clinician orders the test to evaluate a patient’s serum for antibodies to Rickettsia. This may be done if the patient presents with symptoms such as fever, nausea, vomiting, loss of appetite, diarrhea, abdominal pain, joint pain, and rashes that do not resolve with treatment. The test may be particularly relevant if the patient has insect bites or recent tick exposure.

5. When to use CPT code 86757

CPT code 86757 should be used when a laboratory performs an immunoassay to evaluate a patient’s serum for antibodies to Rickettsia. It should not be used for antigen detection.

6. Documentation requirements

To support a claim for CPT 86757, the documentation should include:

• Reason for ordering the test, such as the patient’s symptoms and potential exposure to Rickettsia
• Details of the immunoassay method used, including any specific steps or modifications
• Date of the test
• Results of the test, indicating whether the antibodies to Rickettsia were detected or not
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86757, ensure that the laboratory performs the immunoassay to evaluate the patient’s serum for antibodies to Rickettsia. It is important to note 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 86757 was added to the Current Procedural Terminology system on January 1, 2001. There have been no updates to the code since its addition.

9. Examples

1. A patient presents with fever, joint pain, and a rash after recent tick exposure. The laboratory performs an immunoassay to evaluate the patient’s serum for antibodies to Rickettsia.
2. A patient with persistent symptoms of nausea, vomiting, and abdominal pain undergoes a test to evaluate their serum for antibodies to Rickettsia.
3. A clinician suspects a patient may have contracted a Rickettsia infection due to their symptoms of fever, loss of appetite, and joint pain. The laboratory performs an immunoassay to confirm the presence of antibodies to Rickettsia in the patient’s serum.
4. A patient presents with a rash that does not resolve with treatment. The clinician orders a test to evaluate the patient’s serum for antibodies to Rickettsia.
5. A patient with a history of tick exposure and persistent joint pain undergoes a test to evaluate their serum for antibodies to Rickettsia.
6. A clinician suspects a patient may have contracted a Rickettsia infection due to their symptoms of fever, diarrhea, and abdominal pain. The laboratory performs an immunoassay to confirm the presence of antibodies to Rickettsia in the patient’s serum.
7. A patient presents with a rash and joint pain after recent tick exposure. The laboratory performs an immunoassay to evaluate the patient’s serum for antibodies to Rickettsia.
8. A patient with persistent symptoms of nausea, vomiting, and joint pain undergoes a test to evaluate their serum for antibodies to Rickettsia.
9. A clinician suspects a patient may have contracted a Rickettsia infection due to their symptoms of fever, loss of appetite, and rash. The laboratory performs an immunoassay to confirm the presence of antibodies to Rickettsia in the patient’s serum.
10. A patient presents with a rash that does not resolve with treatment. The clinician orders a test to evaluate the patient’s serum for antibodies to Rickettsia.