2025 CPT code 86355
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Immunology Procedures Pathology and Laboratory Procedures Feed
This code reports the total quantitative B cell count using flow cytometry.
Modifiers may be applicable based on specific circumstances (e.g., 59 for distinct procedural service, -25 for significant, separately identifiable evaluation and management service). Refer to the NCCI edits for further guidance.
Medical necessity for a quantitative B cell count is established by the physician's clinical judgment based on the patient's symptoms, medical history, and other clinical findings suggestive of an immune disorder.Specific payer policies should also be consulted.
The clinical responsibility lies with the laboratory personnel who perform the technical aspects of the test using flow cytometry.The ordering physician is responsible for interpreting the results in the context of the patient's clinical presentation and ordering further tests if needed.
In simple words: This lab test measures the exact number of B cells (a type of infection-fighting white blood cell) in your blood.It helps doctors understand how well your immune system is working.
This CPT code, 86355, encompasses the analytical procedure of quantitatively determining the total number of B cells within a patient's sample, typically blood, using flow cytometry.The process involves preparing the sample, staining cells with a fluorescent dye, analyzing the stained cells via flow cytometry, and reporting the quantitative results. This test is frequently ordered to assess immune system function, identify potential immunodeficiencies or dysfunctions, and aid in the diagnosis and management of various hematological malignancies.
Example 1: A patient presents with recurrent infections.The physician orders a B cell count to assess for potential immunodeficiency., A patient with suspected lymphoma undergoes flow cytometry analysis to determine the type and number of B cells present., A patient with a history of autoimmune disease has a B cell count performed to monitor disease activity and response to therapy.
* Physician's order specifying the test.* Patient demographics and relevant medical history.* Properly labeled and collected blood sample.* Flow cytometry report with quantitative B cell count.
** Always check payer-specific guidelines for coding and reimbursement policies.Proper documentation is crucial to ensure accurate coding and successful claims processing.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: Information regarding RVUs, payment rates, and CMS conversion factors is not available in the provided source.
- Global Days: Not applicable for laboratory tests.
- Payment Status: Active
- Modifier TC rule: Not applicable to this laboratory test.
- Fee Schedule: Fee schedule information is not provided. Refer to established fee schedules and payer contracts for reimbursement details.
- Specialties:Hematology, Immunology, Oncology, Rheumatology
- Place of Service:Office, Hospital (Inpatient/Outpatient), Laboratory