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The CPT® Code 86226 refers to a laboratory test that measures the presence of single stranded deoxyribonucleic acid (DNA) antibodies, specifically the IgG type. This test is significant in the diagnostic process for various autoimmune conditions, particularly systemic lupus erythematosus (SLE). Elevated levels of single stranded DNA antibodies can be indicative of both active and inactive phases of SLE, as well as other medical conditions such as infectious mononucleosis, autoimmune hepatitis, acute and chronic myeloid leukemia, acute lymphatic leukemia, and juvenile rheumatoid arthritis. Additionally, drug-induced SLE may also result in increased levels of these antibodies. It is important to note that while this test focuses on single stranded DNA antibodies, it is often performed alongside a separate test for double stranded DNA antibodies, coded as 86225. This combination allows healthcare providers to calculate the ratio of double stranded DNA IgG to single stranded DNA IgG, which is crucial for differentiating SLE from other disorders. The test is conducted using a blood sample obtained through venipuncture, and the serum is analyzed using a semi-quantitative enzyme-linked immunosorbent assay (ELISA) method, providing a reliable measure of the antibody levels present in the patient's serum.
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The test coded as CPT® 86226 is indicated for the evaluation of various conditions associated with elevated levels of single stranded deoxyribonucleic acid (DNA) antibodies. The specific indications for performing this test include:
The procedure for conducting the test associated with CPT® 86226 involves several key steps that ensure accurate measurement of single stranded DNA antibodies. The first step is obtaining a blood sample from the patient, which is performed through a venipuncture. This process involves inserting a needle into a vein, typically in the arm, to draw blood into a collection tube. Once the blood sample is collected, it is processed to separate the serum from the cellular components. The serum is then subjected to a semi-quantitative enzyme-linked immunosorbent assay (ELISA). This testing method utilizes specific antibodies that bind to the single stranded DNA antibodies present in the serum, allowing for the quantification of these antibodies. The results of this assay provide valuable information regarding the levels of single stranded DNA antibodies, which can aid in the diagnosis and management of the aforementioned conditions.
After the procedure, the patient may experience minimal discomfort at the venipuncture site, which typically resolves quickly. There are no specific post-procedure care instructions required for this test, as it is a routine laboratory procedure. However, patients should be advised to monitor the site for any unusual swelling or prolonged bleeding. The results of the test will be analyzed and reported to the healthcare provider, who will interpret the findings in the context of the patient's clinical presentation and history. It is important for the provider to consider the results of this test alongside other diagnostic tests, particularly the double stranded DNA antibody test (CPT® 86225), to arrive at an accurate diagnosis and appropriate treatment plan.
| Short Descr | DNA ANTIBODY SINGLE STRAND | Medium Descr | DNA ANTIBODY SINGLE STRANDED | Long Descr | Deoxyribonucleic acid (DNA) antibody; single stranded | 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 |
| 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2011-01-01 | Changed | Short description changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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