How To Use CPT Code 86789

CPT 86789 describes the immunoassay procedure used to evaluate a patient’s serum or cerebrospinal fluid for antibodies other than IgM to West Nile virus. 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 86789?

CPT 86789 can be used to describe the immunoassay procedure performed by a lab analyst to evaluate a patient’s serum or cerebrospinal fluid for antibodies other than IgM to West Nile virus. This code is used when the lab analyst performs the technical steps to test the patient’s sample using an immunoassay method, such as enzyme-linked immunosorbent assay (ELISA), to detect the presence of antibodies to West Nile virus.

2. Official Description

The official description of CPT code 86789 is: ‘Antibody; West Nile virus (excluding IgM)’. This code is used to identify the presence of antibodies other than IgM to West Nile virus in a patient’s serum or cerebrospinal fluid.

3. Procedure

1. The lab analyst receives the patient’s serum or cerebrospinal fluid sample for testing.
2. The lab analyst performs an immunoassay, such as ELISA, to evaluate the sample for antibodies other than IgM to West Nile virus.
3. The immunoassay may involve various steps, including reacting the specimen with test antigens, incubating the mixture, adding an agent to detect the antigen-antibody complex, and interpreting the results as positive, negative, or semiquantitative.
4. The lab analyst determines the presence or absence of antibodies other than IgM to West Nile virus in the patient’s sample.

4. Qualifying circumstances

CPT 86789 is used when a patient’s serum or cerebrospinal fluid sample is tested for antibodies other than IgM to West Nile virus. This test may be ordered by clinicians to help diagnose past or current infection with West Nile virus, a mosquito-borne infection that can cause fever, muscle pain, rash, encephalitis, or meningitis. The test is performed by a lab analyst using an immunoassay method, such as ELISA, to detect the presence of specific antibodies in the patient’s sample.

5. When to use CPT code 86789

CPT code 86789 should be used when a patient’s serum or cerebrospinal fluid sample is tested for antibodies other than IgM to West Nile virus. This code should not be used for antigen detection. If the test is specifically for IgM antibodies to West Nile virus, CPT code 86788 should be used instead.

6. Documentation requirements

To support a claim for CPT code 86789, the documentation should include:

• Indication for testing and the reason for ordering the test
• Details of the immunoassay method used, such as ELISA
• Date of the test and the results (positive, negative, or semiquantitative)
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT code 86789, ensure that the test is performed by a lab analyst using an immunoassay method to evaluate the patient’s serum or cerebrospinal fluid for antibodies other than IgM to West Nile virus. This code should not be reported for antigen detection. It is important to follow the specific guidelines provided by the payer for accurate billing and reimbursement.

8. Historical information

CPT code 86789 was added to the Current Procedural Terminology system on January 1, 2007. There have been no updates or changes to the code since its addition.

9. Examples

1. A lab analyst performs an immunoassay to evaluate a patient’s serum for antibodies other than IgM to West Nile virus.
2. A lab analyst uses ELISA to test a patient’s cerebrospinal fluid for antibodies other than IgM to West Nile virus.
3. A patient’s serum sample is tested by a lab analyst for antibodies other than IgM to West Nile virus using an immunoassay method.
4. A lab analyst interprets the results of an immunoassay performed on a patient’s cerebrospinal fluid to detect antibodies other than IgM to West Nile virus.
5. An immunoassay is performed by a lab analyst to evaluate a patient’s serum for the presence of antibodies other than IgM to West Nile virus.
6. A lab analyst uses ELISA to test a patient’s cerebrospinal fluid for the presence of antibodies other than IgM to West Nile virus.
7. A patient’s serum sample is tested by a lab analyst for the presence of antibodies other than IgM to West Nile virus using an immunoassay method.
8. A lab analyst interprets the results of an immunoassay performed on a patient’s cerebrospinal fluid to detect antibodies other than IgM to West Nile virus.
9. An immunoassay is performed by a lab analyst to evaluate a patient’s serum for antibodies other than IgM to West Nile virus.
10. A lab analyst uses ELISA to test a patient’s cerebrospinal fluid for antibodies other than IgM to West Nile virus.