2025 CPT code 86328
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Laboratory - Immunology Procedures Pathology and Laboratory Procedures Feed
Single-step immunoassay for SARS-CoV-2 antibodies (qualitative or semiquantitative).
Modifiers may be applicable depending on the circumstances of service.Consult CPT guidelines and payer specific requirements for applicable modifiers (e.g., 90 for outside lab, 91 for repeat test).
Medical necessity is established when a physician orders this test based on a valid clinical indication, such as evaluating a patient for possible past or current infection, screening potential blood donors, or monitoring post-exposure.
The lab analyst is responsible for performing the test and interpreting the results. The ordering physician is responsible for the clinical interpretation and patient management based on the results.
In simple words: This lab test checks a blood sample for antibodies against the COVID-19 virus.It uses a simple, one-step method to see if you have antibodies, which means your body has fought off the virus at some point.
This CPT code, 86328, reports a single-step immunoassay to qualitatively or semiquantitatively detect antibodies to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus in a patient specimen.The method typically involves a reagent strip containing specific antigens that react with antibodies in the sample (e.g., whole blood or serum), producing a color change. This test may be used to evaluate past infection, identify potential plasma donors, or assess current infection status.
Example 1: A patient presents with symptoms suggestive of past COVID-19 infection. The physician orders this test to confirm prior exposure and assess immunity., A blood bank needs to screen potential donors for COVID-19 antibodies to identify suitable plasma donors for patients with severe COVID-19., A patient is being monitored for COVID-19 symptoms after exposure. This test is used to determine if an infection is developing.
Patient demographics, date of service, specimen type (e.g., serum, whole blood), test results, and the method used for the immunoassay.Physician's order for the test and clinical indication for testing should be documented.
** This code is specifically for SARS-CoV-2 antibody testing.Always verify payer-specific coding and reimbursement guidelines before billing.
- Revenue Code: T1H (LAB TESTS - OTHER)
- RVU: Information not available in provided text.RVUs vary based on geographic location and payer.
- Global Days: Not applicable; this is a lab test.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not typically applicable to this code.
- Fee Schedule: Fee schedules are payer and location specific and vary over time. This information is not available in the provided text.
- Specialties:Infectious Disease, Immunology, Pathology, Emergency Medicine, Family Medicine
- Place of Service:Office, Hospital, Clinical Laboratory, Urgent Care Facility, Outpatient Setting,Telehealth (if applicable and compliant with payer rules)