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The CPT® Code 86360 refers to a laboratory test that measures the absolute counts of two specific types of T-cells: CD4 and CD8, along with the ratio between these two cell types. T-cells are a crucial component of the immune system, specifically classified as lymphocytes, which play a significant role in cell-mediated immunity. The CD4 T-cells, often referred to as helper T-cells, assist in orchestrating the immune response, while CD8 T-cells, known as suppressor or cytotoxic T-cells, are primarily involved in directly killing infected or cancerous cells. This test is particularly important in the context of HIV, as the virus specifically targets and destroys CD4 cells, making the measurement of their count essential for monitoring the progression of HIV infection and the effectiveness of antiretroviral therapy. In addition to its primary use in HIV management, the absolute CD4 and CD8 count test is also valuable in diagnosing and monitoring other medical conditions, including lymphoma, assessing post-transplant immune status, and evaluating patients with DiGeorge Syndrome, a genetic disorder that affects T-cell development. The test is performed on a blood sample, which is typically obtained through venipuncture, and utilizes quantitative flow cytometry to provide accurate measurements of the T-cell populations.
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The absolute CD4 and CD8 count test is indicated for several clinical scenarios, particularly in the context of immune system assessment and monitoring. The following conditions and situations warrant the performance of this test:
The procedure for obtaining the absolute CD4 and CD8 count involves several key steps that ensure accurate results. First, a qualified healthcare professional performs venipuncture to collect a blood sample from the patient. This step is crucial as it provides the whole blood necessary for the test. Once the blood sample is obtained, it is processed using quantitative flow cytometry, a sophisticated laboratory technique that allows for the precise measurement of different cell populations within the blood. During this process, the blood is labeled with specific antibodies that bind to the CD4 and CD8 T-cells, enabling their identification and quantification. The flow cytometer then analyzes the sample, counting the number of CD4 and CD8 cells and calculating the ratio between them. This detailed analysis provides valuable information regarding the patient's immune status and is essential for making informed clinical decisions.
After the procedure, patients may experience minimal discomfort at the venipuncture site, which typically resolves quickly. There are no specific post-procedure care requirements for this test, and patients can generally resume their normal activities immediately. However, it is important for healthcare providers to communicate the significance of the test results to the patient, as these results will guide further management and treatment decisions, particularly in the context of HIV and other immune-related conditions. Follow-up appointments may be necessary to discuss the results and any subsequent actions required based on the findings.
| Short Descr | T CELL ABSOLUTE COUNT/RATIO | Medium Descr | T CELLS ABSOLUTE CD4&CD8 COUNT RATIO | Long Descr | T cells; absolute CD4 and CD8 count, including ratio | 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 | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | 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. | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q4 | Service for ordering/referring physician qualifies as a service exemption | 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. | 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. | 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 | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2011-01-01 | Changed | Short description changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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