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The CPT® Code 86340 refers to the laboratory test for the detection of intrinsic factor antibodies (IFBA) in the blood. This test is crucial for identifying the presence of antibodies that block the action of intrinsic factor, a protein produced in the stomach that is essential for the absorption of vitamin B12. Vitamin B12 is vital for the production of red blood cells and the maintenance of the nervous system. The intrinsic factor binds to free vitamin B12 and transports it to specific receptors in the ileal mucosa, facilitating its absorption in the small intestine. When intrinsic factor is absent, it can lead to a condition known as pernicious anemia (PA), which is characterized by the inability to absorb vitamin B12 effectively. The presence of intrinsic factor antibodies is significant as they are found in approximately 50% of individuals diagnosed with pernicious anemia. However, these antibodies may also be present in patients with other autoimmune conditions, such as autoimmune thyroid disease, type 1 diabetes mellitus, and rheumatoid arthritis. The test is performed by obtaining a blood sample through a venipuncture, which is a procedure that can be reported separately. The serum obtained from the blood sample is then analyzed using a qualitative enzyme-linked immunosorbent assay (ELISA) to determine the presence of these antibodies.
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The CPT® Code 86340 is indicated for the following conditions and symptoms:
The procedure for testing intrinsic factor antibodies involves several key steps:
After the procedure, the patient may experience minor discomfort or bruising at the venipuncture site, which typically resolves quickly. There are no specific post-procedure care instructions required for this test, but patients should be advised to report any unusual symptoms or prolonged discomfort. The results of the test will be communicated to the healthcare provider, who will interpret the findings in the context of the patient's overall clinical picture and may recommend further evaluation or treatment based on the results.
| Short Descr | INTRINSIC FACTOR ANTIBODY | Medium Descr | INTRINSIC FACTOR ANTIBODIES | Long Descr | Intrinsic factor antibodies | 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. | 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 | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | 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 |
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| Pre-1990 | Added | Code added. |
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