2025 CPT code 86793
Effective Date: N/A Pathology and Laboratory Procedures > Immunology Procedures Feed
Antibody; Yersinia
Modifiers may be applicable.Commonly used modifiers include 90 (Reference [Outside] Laboratory), 91 (Repeat Clinical Diagnostic Laboratory Test), and 99 (Multiple Modifiers).
Medical necessity for 86793 is established when the patient presents with signs and symptoms suggestive of a Yersinia infection or related conditions like reactive arthritis, colitis, or thyroiditis. The test results are used to confirm or rule out Yersinia as the underlying cause, guiding treatment decisions.
The lab analyst performs the technical steps to test the patient’s sample for antibodies to Yersinia using an immunoassay method.Clinicians typically order this test to help diagnose disorders linked to Yersinia enterocolitica infection, such as reactive arthritis, colitis, and thyroiditis.
In simple words: This test checks your blood for signs of a past or current infection with Yersinia bacteria, which can cause digestive problems and joint pain.
A lab analyst performs an immunoassay to evaluate the patient’s serum for antibodies to Yersinia, bacteria that can cause gastroenteritis and reactive arthritis. The test may include various steps such as reacting the specimen with test antigens, incubating the mixture, adding an agent to detect the antigen antibody complex, and interpreting the results.
Example 1: A patient presents with persistent abdominal pain, bloody diarrhea, and fever. The physician orders the 86793 test to check for Yersinia infection as a possible cause., A patient with a recent history of gastroenteritis develops joint pain and stiffness.The 86793 test is ordered to investigate the possibility of reactive arthritis triggered by a previous Yersinia infection., A patient experiencing symptoms of thyroiditis undergoes the 86793 test to determine if a Yersinia infection might be contributing to the thyroid inflammation.
Documentation should include the patient's symptoms, relevant medical history (e.g., recent gastroenteritis, joint pain), and the reason for ordering the test. The type of immunoassay performed should also be documented.
** Some payers may reimburse separately for specimen collection (e.g., 36415 for venipuncture).
- Revenue Code: T1H - LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE)
- Specialties:Pathology, Infectious Disease, Rheumatology, Gastroenterology, Endocrinology
- Place of Service:Independent Laboratory, Hospital Outpatient, Office