2025 CPT code 86015
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Qualitative or Semiquantitative Immunoassays Immunology Procedures Feed
This code reports the qualitative or semiquantitative immunoassay for the detection of actin (smooth muscle) antibody (ASMA).
Modifiers may be applicable depending on the specific circumstances of the test performance (e.g., modifier 90 for outside lab, modifier 91 for repeat testing). Consult payer guidelines.
Medical necessity for 86015 is established when a patient presents with clinical symptoms or findings suggestive of autoimmune hepatitis or other conditions where ASMA detection is relevant for diagnosis or monitoring.
The clinical responsibility lies with the laboratory analyst who performs the immunoassay to detect the presence of ASMA antibodies.Clinicians order the test to aid in the diagnosis of liver inflammation and diseases like autoimmune hepatitis.
In simple words: This lab test checks for a specific antibody in your blood that can indicate autoimmune hepatitis, a liver disease where the body's immune system attacks the liver.The test helps doctors determine if you have this condition.
CPT code 86015 represents a qualitative or semiquantitative immunoassay used to identify the presence of antibodies to actin (smooth muscle) (ASMA) in a patient specimen, typically serum.Common methods include enzyme-linked immunosorbent assay (ELISA). This test assists in the differential diagnosis of various forms of hepatitis, most notably autoimmune hepatitis (AIH), a chronic liver inflammation resulting from the body's immune system attacking its own liver cells. The test result, in conjunction with other clinical findings, aids in AIH diagnosis.One unit of 86015 covers testing for a single antibody to actin (smooth muscle), such as a single immunoglobulin (Ig) class.If positive, a separate billable test (titer) may be performed to quantify antibody levels.
Example 1: A patient presents with symptoms suggestive of autoimmune hepatitis (AIH).The physician orders an ASMA test (86015) to help confirm or rule out the diagnosis. A positive result, combined with other clinical findings, supports an AIH diagnosis., A patient with chronic liver inflammation undergoes comprehensive testing.The physician includes an ASMA test (86015) as part of the panel to evaluate various causes of hepatitis., A patient with a previous positive ASMA test undergoes follow-up testing.The physician orders a repeat ASMA test (86015) to monitor disease progression or treatment response. The physician also orders a titer test to check the antibody level.
Physician order specifying the ASMA test (86015). Patient demographics and relevant medical history.Lab report indicating the test method (e.g., ELISA), results (qualitative or semiquantitative), and date of service.If positive, additional documentation may include the titer result.
** Some payers may separately reimburse for specimen collection. Always consult with the payer regarding their specific coding and reimbursement policies.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- Payment Status: Active
- Specialties:Gastroenterology, Hepatology, Rheumatology, Immunology
- Place of Service:Office, Hospital (Inpatient or Outpatient), Clinical Laboratory