2025 CPT code 86580
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Immunology Procedures Pathology and Laboratory Procedures Feed
Intradermal tuberculin skin test for tuberculosis detection; includes test administration and reading.
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.
- Pathology and Laboratory Procedures
- Immunology Procedures; Qualitative or Semiquantitative Immunoassays
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.
- Revenue Code: T1G (LAB TESTS - OTHER)
- RVU: This information is not available in the provided sources.RVUs vary by payer and location and are subject to change. Consult your specific payer's fee schedule.
- Global Days: Not applicable. This is not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: The technical component (TC) is typically included in this code.Modifier 26 should be applied if the physician separately bills for the interpretation of the test results. Consult the most up-to-date NCCI edits for further clarification.
- Fee Schedule: This information is not available in the provided sources. Historical fee schedules vary widely by payer, location, and date.Consult your specific payer's historical fee schedules for details.
- Specialties:Infectious Disease, Pulmonology, Family Medicine, Internal Medicine
- Place of Service:Office, Clinic, Hospital (Inpatient or Outpatient), Other