2025 CPT code 86318
(Active) Effective Date: N/A Immunoassay - Immunology Pathology and Laboratory Feed
Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (e.g., reagent strip).
Modifiers may be applicable. Modifier 59 may be used to indicate a distinct procedural service. Modifier 90 indicates the test was performed by an outside laboratory. Modifier 91 is used for repeat tests.
Medical necessity is established by the clinical indication for the test. The documentation should clearly demonstrate why the test is necessary for the patient's diagnosis or treatment.
The lab analyst performs the technical aspects of the test, including preparing the sample and interpreting the results. Clinicians order the test to evaluate for unspecified infectious agents when a more targeted test is not available or appropriate.
In simple words: This test checks your blood for signs of infection by looking for antibodies (proteins your body makes to fight off germs). It's a quick test that uses a special strip that changes color if antibodies are present.
This code represents a single-step immunoassay performed to qualitatively or semiquantitatively evaluate a patient specimen (such as blood) for antibodies to an unspecified infectious agent. It uses methods like chromatographic immunoassay, which produces a color change when antibodies in the specimen react with specific antigens on a reagent test strip.
Example 1: A patient presents with general symptoms suggestive of an infection, but the specific pathogen is unknown. This test can be used as a preliminary screening tool before more specific tests are ordered., In a point-of-care setting, a rapid test is needed to determine if a patient has antibodies to a certain class of infectious agents., A patient has a known history of exposure to an infectious agent, and this test is used to check for seroconversion (development of antibodies).
Documentation should include the reason for the test, the type of specimen collected, the date of the test, and the results. Any relevant clinical findings or suspected diagnoses should also be documented.
** Specimen collection may be billed separately using codes such as 36415. Always check for more specific codes before using this unlisted code.
- Revenue Code: T1H - LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE)
- Payment Status: Active
- Specialties:Pathology, Infectious Disease
- Place of Service:Independent Laboratory, Office, Outpatient Hospital, etc.