2025 CPT code 86376
(Active) Effective Date: N/A Pathology and Laboratory Procedures - Immunology Pathology and Laboratory Feed
Microsomal antibodies (e.g., thyroid or liver-kidney), each.
Modifiers may be applicable. For example, modifier 91 is used for repeat laboratory tests performed on the same day.
Medical necessity for this test must be established by linking the test to the patient's signs, symptoms, and clinical condition.The documentation should clearly indicate why the test is necessary for diagnosis, treatment, or management of the patient's condition.
Laboratory professionals perform the technical analysis of the specimen, interpreting the results and reporting them to the ordering clinician. The clinician is responsible for ordering the test, correlating the results with the patient's clinical picture, and making treatment decisions.
In simple words: This test looks for special proteins called antibodies in your blood that may be attacking your own body tissues, specifically those found in your liver, kidney, or thyroid. These "microsomal antibodies" can cause certain types of hepatitis or thyroid disease. The test helps doctors figure out if you have these diseases and how they are progressing.
This code represents the qualitative or semiquantitative analysis of microsomal antibodies in a patient sample, typically serum.These antibodies, such as liver-kidney microsomal antibody (LKM-1) and thyroid peroxidase antibody (TPO), are autoantibodies associated with certain autoimmune diseases like autoimmune hepatitis type 2 and autoimmune thyroid disease. The test helps in diagnosing and monitoring these conditions.Methodologies may include enzyme-linked immunosorbent assays (ELISA) or electrochemiluminescence immunoassays (ECLIA).
Example 1: A pediatrician suspects autoimmune hepatitis type 2 in a young child presenting with jaundice, fatigue, and elevated liver enzymes.The pediatrician orders a microsomal antibody test (CPT 86376) to check for the presence of LKM-1 antibodies., An endocrinologist is evaluating a patient with symptoms suggestive of Hashimoto's thyroiditis, such as fatigue, weight gain, and dry skin. They order a microsomal antibody test (CPT 86376) to detect TPO antibodies., A patient with a known diagnosis of autoimmune hepatitis is undergoing regular monitoring to assess disease activity.Their physician orders a microsomal antibody test (CPT 86376) to track LKM-1 antibody levels.
Documentation should include the reason for the test, the patient's relevant medical history, and the interpretation of the test results in the context of the patient's clinical presentation.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- Payment Status: Active
- Specialties:Pediatrics, Endocrinology, Gastroenterology, Hepatology, Immunology
- Place of Service:Independent Laboratory, Outpatient Hospital, Physician Office