Start New EnglishEspañol中文РусскийالعربيةTiếng ViệtFrançaisDeutsch한국어Tagalog Library Performance
BETA v.3.0

2025 CPT code 86580

Intradermal tuberculin skin test for tuberculosis detection; includes test administration and reading.

Follow the current CPT coding guidelines for immunology procedures and laboratory tests. Adhere to local and payer-specific guidelines.

Modifiers may be applied as appropriate.For example, modifier 26 may be used if the physician's interpretation of the results is reported separately from the technical component performed by the laboratory. Consult your payer's guidelines for specific modifier requirements.

Medical necessity for a tuberculin skin test is established by a reasonable clinical suspicion of latent or active tuberculosis infection based on risk factors such as recent exposure to an individual with active TB, travel to high-prevalence areas, immune deficiency, or certain medical conditions.Pre-employment screening may also be a valid reason depending on the payer's guidelines. The test is not medically necessary if performed solely for screening purposes without a clinical indication.

The responsibility for this test involves both the clinician ordering the test and the laboratory personnel performing it. The clinician is responsible for ordering the test based on clinical suspicion, interpreting the results, and initiating further investigations as necessary. The laboratory personnel is responsible for administering the PPD intradermally, following proper technique, and accurately measuring and reporting the results.

IMPORTANT:This code should not be used for allergy skin tests (95012-95199) or other immunology analytes not specified in 86015-86835 or the Chemistry subsection (82009-84830). For gamma interferon antigen response measurement, use 86480.For smooth muscle antibody testing, use 86015.A separate E/M code (e.g., 99211) may be reported for the interpretation of results if this is the primary purpose of the visit. Injection codes should not be reported separately.

In simple words: This code covers a skin test to check for tuberculosis.A small amount of medicine is injected under the skin, and the area is checked a few days later to see if there's a reaction.

This CPT code encompasses the complete procedure for an intradermal tuberculin skin test to detect tuberculosis.It includes the preparation of the injection site, administration of a standardized concentration of purified protein derivative (PPD) intradermally, and the subsequent reading and interpretation of the results 48-72 hours later. The test assesses the patient's cell-mediated immune response to the PPD antigen.

Example 1: A patient presents with symptoms suggestive of latent tuberculosis infection. The physician orders a tuberculin skin test (TST) to assess for evidence of prior Mycobacterium tuberculosis infection. The test is administered by a medical assistant or nurse and read 72 hours later by a physician., An asymptomatic individual requires a TST for pre-employment screening.The test is performed and read according to standard protocols.No further evaluation is needed if the results are negative., A patient with a history of recent close contact with a person with active TB undergoes TST.The test result is positive, necessitating further evaluation with chest x-ray and potentially additional tests to determine if the TB infection is active.

** The reading of the test is usually performed 48-72 hours after administration.If the reading is performed on a different day, a separate E/M code may be appropriate, depending on the clinical context and payer requirements.Pay close attention to the payer's policy on payment for this service.Some payers may deny claims for screening tests without a documented medical indication.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

Discover what matters.

iFrame™ AI's knowledge is aligned with and limited to the materials uploaded by users and should not be interpreted as medical, legal, or any other form of advice by iFrame™.