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The CPT® Code 86063 refers to the screening for antistreptolysin O (ASO) antibodies in a blood sample. This procedure is essential for detecting the presence of ASO antibodies, which are produced in response to infection by Group A Streptococcus bacteria. The presence of these antibodies can be indicative of various medical conditions, including active streptococcal infections, bacterial endocarditis, post-streptococcal glomerulonephritis, rheumatic fever, and scarlet fever. The ASO screening can be performed using different laboratory methods, such as nephelometry and latex immunoturbidimetry, which help in determining the concentration of these antibodies in the blood. While the ASO titer, represented by CPT® Code 86060, provides a quantitative measurement expressed in Todd units per milliliter, CPT® Code 86063 focuses solely on the qualitative aspect, indicating whether ASO antibodies are present or absent in the sample. This distinction is crucial for healthcare professionals in diagnosing and managing streptococcal-related conditions.
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The procedure associated with CPT® Code 86063 is indicated for the following conditions:
The procedure for CPT® Code 86063 involves several key steps to ensure accurate screening for ASO antibodies:
After the ASO screening procedure, the patient may not require any specific post-procedure care, as the blood draw is a routine and minimally invasive process. However, it is essential for healthcare providers to review the results with the patient, especially if the test indicates the presence of ASO antibodies. Further evaluation or treatment may be necessary based on the results and the patient's clinical presentation. Follow-up appointments may be scheduled to discuss the implications of the findings and any additional testing or interventions that may be warranted.
| Short Descr | ANTISTREPTOLYSIN O SCREEN | Medium Descr | ANTISTREPTOLYSIN O SCREEN | Long Descr | Antistreptolysin 0; screen | 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 | 1 | 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. | GW | Service not related to the hospice patient's terminal condition | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 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. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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