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The CPT® Code 86309 refers to the laboratory test that measures the titer of heterophile antibodies in a blood sample. Heterophile antibodies are typically associated with the Epstein-Barr virus (EBV), which is known to cause infectious mononucleosis (IM). This test is crucial for diagnosing IM, particularly when a patient presents with symptoms such as fever, headache, sore throat, swollen lymph nodes, fatigue, and abdominal discomfort. The presence of these antibodies indicates an immune response to the EBV infection. It is important to note that the test may yield negative results during the early stages of the infection, necessitating a repeat test if symptoms continue. Additionally, infants and young children may not produce heterophile antibodies, resulting in negative test outcomes despite having an EBV infection. The blood sample for this test is collected through venipuncture, and the analysis is performed using a semiquantitative latex agglutination method. When the initial screening test for heterophile antibodies is positive, the titer measurement is reported using CPT® Code 86309, providing further insight into the level of antibodies present in the patient's serum or plasma.
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The CPT® Code 86309 is indicated for use in the following scenarios:
The procedure for performing the test associated with CPT® Code 86309 involves several key steps:
After the procedure, the patient may be advised on the expected timeline for receiving test results. It is important to note that if the test results are negative but symptoms persist, a repeat test may be necessary due to the possibility of early-stage infection. Additionally, healthcare providers should consider the patient's clinical presentation and history when interpreting the results, as infants and young children may not produce heterophile antibodies, leading to negative test outcomes despite the presence of EBV infection. Proper documentation of the test results and any follow-up actions is essential for ongoing patient care.
| Short Descr | HETEROPHILE ANTIBODY TITER | Medium Descr | HETEROPHILE ANTIBODIES TITER | Long Descr | Heterophile antibodies; titer | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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