2025 CPT code 86359
(Active) Effective Date: N/A Revision Date: N/A Pathology and Laboratory Procedures - Qualitative or Semiquantitative Immunoassays Immunology Procedures Feed
This code reports the total count of T cells in a blood sample.
Modifiers may apply depending on the circumstances of service. Consult the official CPT manual and payer-specific guidelines for appropriate modifier usage.
Medical necessity for a T-cell total count is established based on the patient's clinical presentation, including symptoms suggestive of immunodeficiency, suspected hematologic malignancy, or monitoring of known conditions such as HIV.Appropriate documentation supporting these clinical indications is required.
The clinical responsibility rests with the laboratory analyst who performs the technical aspects of the test, including sample preparation, cell separation and identification, and quantification of the T cell count. The ordering physician is responsible for interpreting the results in the context of the patient's clinical presentation and ordering the test appropriately.
In simple words: This lab test measures the number of T cells in your blood. T cells are a type of white blood cell that fights infection. A doctor might order this test if you have a weakened immune system or a possible blood cancer.
CPT code 86359 represents the total count of T cells, typically measured in a blood specimen.This test is frequently ordered to assess immune system function, particularly in patients with suspected immunodeficiency or to differentiate between cancerous and non-cancerous diseases, especially those affecting the bone marrow and blood. The procedure involves the technical steps of separating lymphocytes and employing identifiers to distinguish T cells. The result is reported as a quantitative measure, typically interpreted as normal, increased, or decreased relative to established reference ranges.While not limited to specific conditions, elevated T cell counts might suggest conditions such as acute lymphoblastic anemia, chronic lymphocytic leukemia, infectious mononucleosis, multiple myeloma, syphilis, toxoplasmosis, or tuberculosis. Decreased counts may indicate HIV infection, HTLV infection, chronic lymphocytic leukemia, or Nezelof syndrome.
Example 1: A patient presents with recurrent infections and fatigue.A T-cell total count (86359) is ordered to evaluate the possibility of an immunodeficiency., A patient with suspected chronic lymphocytic leukemia undergoes a comprehensive blood workup, which includes a T-cell total count (86359) to assess the relative proportions of various lymphocytes., A patient with HIV undergoes routine monitoring which includes a T-cell total count (86359) to assess the status of their immune system and guide treatment decisions.
* Patient demographics* Physician order specifying the test* Specimen collection and handling information (date, time, type of specimen)* Test results with units and reference range.* Clinician's interpretation of the results in the context of the patient's medical history and clinical presentation.
** This code represents a quantitative measurement of T cells.It does not include any interpretation of the results, which is the responsibility of the ordering physician.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: Information not available in provided sources.Consult current RVU data for accurate values.
- Global Days: Not applicable. This is a laboratory test, not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is a complete laboratory test and does not have separate professional and technical components.
- Fee Schedule: Information not available in provided sources.Refer to historical fee schedules from relevant payers.
- Specialties:Hematology, Immunology, Oncology, Infectious Disease
- Place of Service:Office (11), Independent Clinic (49), Federally Qualified Health Center (50), Rural Health Clinic (72), Independent Laboratory (81)