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CPT® Code 86318 refers to an immunoassay procedure designed to detect the presence of antibodies against infectious agents. This code specifically applies to qualitative or semiquantitative testing methods that utilize a single-step approach, such as reagent strips or dipsticks. The primary purpose of this immunoassay is to identify whether antibodies are present in a patient's sample, indicating exposure to specific infectious agents. The results from this type of testing are typically available within a short timeframe, usually between 5 to 10 minutes, making it a rapid diagnostic tool. Common infectious agents that may be screened using this method include Helicobacter pylori, influenza viruses (types A and B), infectious mononucleosis, respiratory syncytial virus (RSV), and group A streptococcus. This code is distinct from other related codes, such as CPT® Code 86317, which is used for quantitative measurements of antibody levels rather than qualitative detection.
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The immunoassay procedure represented by CPT® Code 86318 is indicated for the detection of antibodies against various infectious agents. This testing is particularly useful in the following scenarios:
The procedure for CPT® Code 86318 involves several key steps to ensure accurate detection of infectious agent antibodies:
Following the immunoassay procedure coded under CPT® 86318, the results are typically available within minutes, allowing for rapid clinical decision-making. If antibodies are detected, further clinical evaluation may be warranted to confirm the diagnosis and determine appropriate treatment options. In cases where the test result is negative, it may still be necessary to consider additional testing or clinical assessments based on the patient's symptoms and medical history. Proper documentation of the test results and any subsequent actions taken is essential for maintaining accurate medical records and ensuring continuity of care.
| Short Descr | IA INFECTIOUS AGENT ANTIBODY | Medium Descr | IA INFECTIOUS AGT ANTIBODY QUAL/SEMIQ 1STEP METH | Long Descr | Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); | 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) | Yes | 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 | 2 | 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. | QW | Clia waived test | CR | Catastrophe/disaster related | 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 | 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 | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | U6 | Medicaid level of care 6, as defined by each state |
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| 2021-01-01 | Changed | First appearance of change in code book. |
| 2020-04-10 | Changed | Code description revised. |
| 2020-01-01 | Changed | Code description changed. |
| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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