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Official Description

B cells, total count

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 86355 refers to a laboratory test that measures the total count of B cells in a blood sample. B cells are a type of white blood cell that plays a crucial role in the immune system, particularly in the production of antibodies. This test is essential for evaluating immune function and is often performed alongside other related tests to provide a comprehensive assessment of a patient's immune status. The total B-cell count can help in diagnosing various conditions, including chronic lymphocytic leukemia, multiple myeloma, Waldenstrom macroglobulinemia, and DiGeorge syndrome, which are associated with elevated B lymphocyte levels. Conversely, decreased B-cell counts may indicate conditions such as acute lymphocytic leukemia and congenital immunoglobulin deficiency syndrome. The procedure involves obtaining a blood sample through venipuncture, which is separately reportable, and the analysis is conducted using quantitative flow cytometry, a sophisticated technique that allows for precise measurement of cell populations in the blood.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The B cells total count test (CPT® Code 86355) is indicated for the assessment of immune function in various clinical scenarios. The following conditions and symptoms may warrant the performance of this test:

  • Chronic Lymphocytic Leukemia - Elevated B lymphocyte levels are often observed in patients with this type of cancer.
  • Multiple Myeloma - This condition is characterized by an increase in B cells, which can be evaluated through this test.
  • Waldenstrom Macroglobulinemia - Patients with this disorder may also show elevated B cell counts.
  • DiGeorge Syndrome - This genetic disorder can lead to abnormal B cell levels, making the test relevant for diagnosis and monitoring.
  • Acute Lymphocytic Leukemia - Decreased B cell levels may be indicative of this condition.
  • Congenital Immunoglobulin Deficiency Syndrome - This syndrome may also present with lower B cell counts, necessitating testing.

2. Procedure

The procedure for obtaining a total B cell count involves several key steps, which are outlined below:

  • Step 1: Patient Preparation - The patient may be instructed to avoid certain medications or foods prior to the blood draw, although specific instructions will depend on the healthcare provider's recommendations.
  • Step 2: Venipuncture - A qualified healthcare professional performs a venipuncture to collect a blood sample. This step is crucial as it provides the specimen needed for the test. The venipuncture is separately reportable, meaning it should be documented and billed as a distinct procedure.
  • Step 3: Sample Handling - The collected blood sample is handled according to laboratory protocols to ensure its integrity. This may involve the use of specific tubes or anticoagulants to prevent clotting.
  • Step 4: Laboratory Analysis - The blood sample is analyzed using quantitative flow cytometry, a technique that allows for the precise measurement of B cell populations. This method involves passing the cells through a laser beam and measuring their characteristics, which provides an accurate count of B cells.
  • Step 5: Reporting Results - Once the analysis is complete, the results are compiled and reported to the healthcare provider, who will interpret the findings in the context of the patient's overall health and any presenting symptoms.

3. Post-Procedure

After the procedure, patients may experience minor discomfort or bruising at the venipuncture site, which typically resolves quickly. There are generally no specific post-procedure care instructions required for this test, but patients should be advised to monitor the site for any signs of excessive bleeding or infection. The healthcare provider will discuss the results of the B cell count with the patient, including any necessary follow-up tests or treatments based on the findings.

Short Descr B CELLS TOTAL COUNT
Medium Descr B CELLS TOTAL COUNT
Long Descr B cells, total count
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.
GZ Item or service expected to be denied as not reasonable and necessary
GA Waiver of liability statement issued as required by payer policy, individual case
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.
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.
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.
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
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2011-01-01 Changed Short description changed.
2006-01-01 Added First appearance in code book in 2006.
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Description
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Description
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