2025 CPT code 86849
(Active) Effective Date: N/A Pathology and Laboratory Procedures - Immunology Pathology and Laboratory Feed
Unlisted immunology procedure.
Modifiers may be applicable depending on the specific context of the procedure.
Medical necessity must be clearly documented and justified. The rationale for using this unlisted code should be explained due to the lack of a specific code for the procedure performed.
The analyst performs the procedure.
In simple words: This code is used for immunology tests not covered by other specific codes.
This code is used to report immunology analytes/procedures that are not otherwise specified in the CPT codebook, specifically those not found within codes 86015-86835 or the Chemistry subsection (82009-84830).
Example 1: A patient presents with unusual symptoms, and a novel immunological test is required to aid in diagnosis, but no specific CPT code exists for the procedure., A research laboratory develops a new immunology test, and it needs to be billed before a specific CPT code is created., A physician orders an immunology test that is a combination of several procedures, each with its own CPT code, but there’s no single code to represent the combined service.
Detailed description of the procedure performed.Rationale for why existing codes are not applicable.Comparison of the procedure to similar procedures with existing codes.Supporting documentation, such as lab reports, to justify the medical necessity.
** For accurate reimbursement, it’s crucial to submit thorough documentation explaining the nature of the unlisted procedure, its medical necessity, and comparable existing codes with their corresponding fees.
- Revenue Code: T1H - LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE)
- Payment Status: Active
- Specialties:Immunology, Pathology, Laboratory
- Place of Service:Independent Laboratory, Office