How To Use CPT Code 86780

CPT 86780 describes the evaluation of a patient’s serum for antibodies to Treponema pallidum, the bacteria that causes syphilis. 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 86780?

CPT 86780 can be used to evaluate a patient’s serum for antibodies to Treponema pallidum, the spiral-shaped bacteria that causes syphilis. This code is used when a lab analyst performs an immunoassay to test the patient’s sample for the presence of these antibodies. The test may involve various steps, such as preparing dilutions of serum, reacting the dilutions with colored particles coated with test antigens, and interpreting the results as positive, negative, or semiquantitative.

2. Official Description

The official description of CPT code 86780 is: ‘Antibody; Treponema pallidum.’

3. Procedure

1. The lab analyst prepares dilutions of the patient’s serum sample.
2. The dilutions are reacted with colored particles coated with test antigens.
3. The mixture is incubated to allow the antibodies in the sample to adhere to the particles and form agglutinins.
4. The lab analyst reads and interprets the results as positive, negative, or semiquantitative.

4. Qualifying circumstances

CPT 86780 is used to confirm current or past infection with Treponema pallidum, the bacteria that causes syphilis. It is not limited to testing for specific conditions, but clinicians may order this test when there is a suspicion of syphilis. The presence of antibodies to T. pallidum in the patient’s serum indicates exposure to the bacteria. It is important to note that antibodies may remain elevated even after successful treatment of the disease.

5. When to use CPT code 86780

CPT code 86780 should be used when a lab analyst performs an immunoassay to evaluate a patient’s serum for antibodies to Treponema pallidum. This code is appropriate when there is a clinical suspicion of syphilis and the test is ordered to confirm or rule out the infection.

6. Documentation requirements

To support a claim for CPT 86780, the documentation should include:

• Clinical indication for the test, such as suspicion of syphilis
• Details of the immunoassay method used
• Date of the test
• Results of the test, including whether it was positive, negative, or semiquantitative
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86780, ensure that the test is performed by a lab analyst using an immunoassay method to evaluate the patient’s serum for antibodies to Treponema pallidum. It is important to note that CPT 86780 should not be used for antigen detection. If antigen detection is required, a different CPT code should be used. It is also important to follow any specific billing guidelines provided by the payer.

8. Historical information

CPT 86780 was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates to the code since its addition.

9. Examples

1. A patient with a suspected syphilis infection undergoes a serum test for antibodies to Treponema pallidum using an immunoassay method.
2. A pregnant woman with a history of syphilis receives a routine screening test to confirm the absence of antibodies to Treponema pallidum.
3. A patient with symptoms consistent with secondary syphilis undergoes a serum test to confirm the presence of antibodies to Treponema pallidum.
4. A patient with a positive rapid plasma reagin (RPR) test undergoes a confirmatory test for antibodies to Treponema pallidum.
5. A patient with a history of treated syphilis undergoes a follow-up test to monitor the persistence of antibodies to Treponema pallidum.