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The CPT® Code 86001 refers to the quantitative or semiquantitative testing of allergen-specific IgG immunoglobulins in a blood sample. This procedure involves obtaining a blood sample from the patient to analyze the presence of IgG antibodies that are specific to various allergens. These allergens may include a range of substances such as foods or venoms that can trigger allergic reactions. Unlike skin tests, which are conducted in vivo, this blood test is categorized as an in vitro test, meaning it is performed outside the body in a laboratory setting. The results of this test can help identify sensitivities to multiple allergens, and it is often utilized in the context of food allergies or insect sting allergies. When testing for sensitivities to several food items, the test may be referred to as a food allergy panel, while testing for multiple venoms may be termed a stinging insect allergy profile. It is important to note that the code 86001 is reported for each individual antigen tested, allowing for detailed tracking and analysis of specific allergen sensitivities.
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The procedure associated with CPT® Code 86001 is indicated for the assessment of allergic reactions to specific allergens. The following conditions may warrant the use of this test:
The procedure for CPT® Code 86001 involves several key steps to ensure accurate testing of allergen-specific IgG immunoglobulins:
After the procedure associated with CPT® Code 86001, patients may experience minimal discomfort at the site of blood collection, which typically resolves quickly. There are no specific post-procedure care requirements; however, patients are advised to monitor the site for any unusual swelling or bruising. The healthcare provider will review the test results with the patient, discussing any identified sensitivities and potential next steps for management or further testing if necessary. It is important for patients to follow up with their healthcare provider to understand the implications of the test results and to develop an appropriate management plan for their allergies.
| Short Descr | ALLERGEN SPECIFIC IGG | Medium Descr | ALLERGEN SPECIFIC IGG QUAN/SEMIQUAN EA ALLERGEN | Long Descr | Allergen specific IgG quantitative or semiquantitative, each allergen | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | CLIA Waived (QW) | No | APC Status Indicator | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 20 | CCS Clinical Classification | 235 - Other Laboratory |
| 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | GA | Waiver of liability statement issued as required by payer policy, individual case | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GZ | Item or service expected to be denied as not reasonable and necessary | F9 | Right hand, fifth digit | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2001-01-01 | Added | First appearance in code book in 2001. |
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