CPT® Code 86310

Official Description

Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney

Common Language Description

Heterophile antibodies are a type of antibody that can be detected in the blood and are commonly associated with infectious mononucleosis (IM). These antibodies typically become elevated during the early stages of the illness, specifically within the first 2 to 3 weeks after the onset of symptoms. Following this initial rise, the titers of heterophile antibodies begin to decline and are generally no longer detectable within 8 to 12 weeks. The testing for these antibodies involves a specific procedure known as the Paul-Bunnell test, which was later refined to include the Davidsohn differential test, collectively referred to as the Paul-Bunnell-Davidsohn test. This test examines serum samples that contain IM antibodies and introduces them to guinea pig kidney cells. It is important to note that the IM antibodies do not get absorbed by the kidney cells; instead, they react with beef (ox) red blood cells, leading to agglutination. The degree of this agglutination indicates the titer level of the heterophile antibodies present in the serum sample, which is a positive indicator for infectious mononucleosis.

1. Indications

The procedure for testing heterophile antibodies is indicated in the following scenarios:

Infectious Mononucleosis (IM) This test is primarily performed to diagnose infectious mononucleosis, a viral infection often caused by the Epstein-Barr virus (EBV), characterized by symptoms such as fever, sore throat, and swollen lymph nodes.

2. Procedure

The procedure for testing heterophile antibodies involves several key steps that ensure accurate results.

Step 1: Sample Collection A blood sample is collected from the patient, typically via venipuncture. This sample will be used to analyze the presence of heterophile antibodies.
Step 2: Serum Preparation The collected blood sample is processed to separate the serum from the cellular components. This is usually done through centrifugation, which allows the serum to be isolated for testing.
Step 3: Reaction with Guinea Pig Kidney Cells The serum is then mixed with guinea pig kidney cells in a controlled laboratory setting. This step is crucial as it helps to identify the presence of IM antibodies, which do not get absorbed by these cells.
Step 4: Reaction with Beef Red Blood Cells Following the interaction with guinea pig kidney cells, the serum is introduced to beef (ox) red blood cells. The presence of heterophile antibodies will cause agglutination of these red blood cells, indicating a positive reaction.
Step 5: Titer Measurement The degree of agglutination is then measured to determine the titer level of heterophile antibodies in the serum. This measurement is essential for diagnosing the presence and severity of infectious mononucleosis.

3. Post-Procedure

After the procedure, the patient may experience no significant side effects, as the blood draw is a routine procedure. The results of the heterophile antibody test are typically available within a few days. It is important for healthcare providers to interpret the results in conjunction with the patient's clinical symptoms and history. If the test is positive, further evaluation and management of infectious mononucleosis may be warranted. Patients should be advised to follow up with their healthcare provider to discuss the results and any necessary next steps in their care.

Short Descr	HETEROPHILE ANTIBODY ABSRBJ
Medium Descr	HETEROPHILE ANTIBODIES TITER AFTER ABSORPTION
Long Descr	Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney
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