2025 CPT code 86431
(Active) Effective Date: N/A Pathology and Laboratory Procedures - Immunology Procedures Feed
Rheumatoid factor; quantitative.
Modifiers may be applicable in certain circumstances. Refer to current CPT guidelines for proper modifier usage.
Medical necessity for this test is established by the presence of signs and symptoms suggestive of rheumatoid arthritis or other autoimmune conditions where RF levels are clinically relevant.
The laboratory analyst performs the technical aspects of the test, including mixing the patient's serum with IgG antigens and using instrumentation to measure the level of agglutination.The results are then reported quantitatively.
In simple words: This blood test measures the level of rheumatoid factor, an antibody often associated with rheumatoid arthritis and some other autoimmune diseases. It helps doctors diagnose and monitor these conditions.
This test quantifies the amount of rheumatoid factor (RF) in the blood. RF is an antibody that is frequently elevated in patients with rheumatoid arthritis, but can also be present in other autoimmune conditions.
Example 1: A patient presents with joint pain, swelling, and stiffness.A quantitative rheumatoid factor test is ordered to aid in the diagnosis of rheumatoid arthritis., A patient with a previously diagnosed autoimmune disease experiences a flare-up of symptoms.The quantitative RF test is used to monitor disease activity and treatment effectiveness., A patient with an elevated qualitative RF test result needs further evaluation. A quantitative RF test is ordered to determine the specific level of RF present.
Documentation should include the reason for the test, relevant clinical findings, and any related diagnoses.
- Revenue Code: T1H - LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE)
- Specialties:Rheumatology, Immunology, Pathology
- Place of Service:Independent Laboratory, Hospital Laboratory