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The CPT® Code 86162 refers to a laboratory test known as the total hemolytic complement (CH50) test. This blood test is specifically designed to measure the activity of the total hemolytic complement system, which is a crucial part of the immune response. The complement system consists of a series of proteins that work together to enhance the ability of antibodies and phagocytic cells to clear pathogens from an organism. The CH50 test evaluates the overall function of this system by assessing how well it can lyse (break down) red blood cells in the presence of complement proteins. The common language description indicates that this code can be utilized for two specific types of tests: the complement activity enzyme immunoassay and the complement activity alternative pathway test. The enzyme immunoassay is a semiquantitative test that measures the activity of the complement system, helping to identify any abnormalities or deficiencies that may be linked to various infectious diseases or inflammatory conditions, such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and vasculitis. Additionally, the alternative pathway test also evaluates the functional activity of the complement system, focusing on a different pathway within the complement cascade. Abnormal results from these tests may suggest either inherited or acquired defects in one or more components of the complement system, which can have significant implications for a patient's health. It is important to note that a blood sample for this test is obtained through a separately reportable venipuncture, ensuring that the sample is collected properly for accurate testing. The testing methodologies employed include semiquantitative enzyme-linked immunosorbent assay for the complement activity enzyme test and semiquantitative radial immunodiffusion for the alternative pathway test.
© Copyright 2026 Coding Ahead. All rights reserved.
The total hemolytic complement (CH50) test, represented by CPT® Code 86162, is indicated for the evaluation of various conditions that may affect the immune system. The following are the specific indications for performing this test:
The procedure for conducting the total hemolytic complement (CH50) test involves several key steps, which are outlined below:
After the total hemolytic complement (CH50) test is completed, the patient may be advised on any necessary follow-up actions based on the results. If the results indicate abnormal complement activity, further diagnostic testing or clinical evaluations may be recommended to determine the underlying cause. Patients are typically informed that they can resume normal activities immediately following the venipuncture, although they should monitor the site for any signs of excessive bleeding or infection. It is also important for healthcare providers to communicate the results to the patient in a timely manner, discussing any implications for their health and potential next steps in management or treatment.
| Short Descr | COMPLEMENT TOTAL (CH50) | Medium Descr | COMPLEMENT TOTAL HEMOLYTIC | Long Descr | Complement; total hemolytic (CH50) | 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. | Q4 | Service for ordering/referring physician qualifies as a service exemption | 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. | 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 | 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 |
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| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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