2025 CPT code 86602
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Pathology and Laboratory Procedures - Qualitative or Semiquantitative Immunoassays Immunology Procedures Feed
Qualitative or semiquantitative immunoassay for detecting antibodies to actinomyces.
Modifiers 91 (repeat test), 99 (multiple procedures), and possibly others depending on payer policy, may be applicable.Consult payer guidelines.
The medical necessity for this test is established when there is clinical suspicion of actinomycosis based on the patient's presentation and symptoms.The test should be medically necessary when other diagnostic methods are inconclusive.
Laboratory personnel perform the technical aspects of the immunoassay; clinicians order and interpret the results for diagnostic purposes.
In simple words: This lab test checks a blood sample for antibodies against a type of bacteria called Actinomyces.The results help doctors diagnose actinomycosis, an infection causing lumps in the mouth, throat, or other areas. The test is done in a lab and involves several steps to identify the antibodies.
This CPT code, 86602, represents a multi-step qualitative or semi-quantitative immunoassay used to detect antibodies against Actinomyces in a patient's serum.The procedure involves several steps, including reacting the specimen with test antigens, incubation, addition of a detection agent (like a stain or fluorescent marker), and interpretation of results as positive, negative, or semi-quantitative.This test may aid in diagnosing actinomycosis, a disease caused by Actinomyces infection, characterized by fibrous lesions in mucous membranes.Reporting this code requires specifying each immunoglobulin class (e.g., IgG, IgM) or each Actinomyces species tested.For single-step methods, use 86318; for quantitative tests, use 86317.
Example 1: A patient presents with lesions in the oral cavity and a suspected diagnosis of actinomycosis. The physician orders a serum immunoassay (86602) to detect Actinomyces antibodies, specifically IgG and IgM subclasses. The results are positive for IgG antibodies, supporting the diagnosis., A patient with a history of pelvic inflammatory disease experiences recurring symptoms and is suspected of having actinomycosis. The laboratory performs an immunoassay (86602) to detect antibodies to Actinomyces israelii. The result aids in confirming the diagnosis, guiding treatment., A patient presents with thoracic symptoms resembling tuberculosis but is also suspected of having actinomycosis. A serum immunoassay (86602) is ordered to test for multiple Actinomyces species, confirming the presence of antibodies specific to a particular species, ruling out tuberculosis and leading to appropriate treatment.
Patient's medical history, symptoms, clinical presentation, details about the specific immunoassay performed (method, antibodies tested), and the results (qualitative or semi-quantitative values).
** Payers may reimburse separately for specimen collection (e.g., venipuncture, code 36415).Always check payer-specific guidelines and local coverage determinations for billing policies.
- Revenue Code: T1H (LAB TESTS - OTHER)
- RVU: Information not available in provided source.
- Global Days: Not applicable for this laboratory test.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is a laboratory test, not a procedure with separate professional and technical components.
- Fee Schedule: Information not available in provided source.
- Specialties:Clinical Microbiology, Infectious Disease, Pathology
- Place of Service:Laboratory