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The CPT® Code 86481 refers to a specific tuberculosis test that measures the cell-mediated immunity (CMI) antigen response by enumerating gamma interferon-producing T-cells in a cell suspension. This test is particularly relevant for individuals who are suspected of having or are at high risk for infection with Mycobacterium tuberculosis, the bacterium that causes tuberculosis (TB). The procedure involves the use of two specific proteins, known as early-secreted antigenic target 6-kDa protein (ESAT-6) and culture filtrate protein (CFP-10), which are integral to the CMI antigen response tests for TB. When a blood sample is collected from the patient, it is subjected to stimulation with these TB-specific proteins. The presence of lymphocytes in the blood that respond to these proteins indicates a potential TB infection. A positive test result is determined by the secretion of cytokine interferon gamma, a protein that plays a crucial role in regulating the immune response. The quantification of both the presence and the amount of interferon gamma in the blood sample is essential for diagnosing TB. It is important to note that CPT® Code 86480 is used when testing blood for gamma interferon CMI antigen response, while CPT® Code 86481 is specifically designated for cases where gamma interferon-producing T-cells in a cell suspension are quantified.
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The tuberculosis test coded as CPT® 86481 is indicated for individuals who are suspected of having or are at high risk for Mycobacterium tuberculosis infection. The following conditions may warrant the performance of this test:
The procedure for CPT® 86481 involves several key steps that ensure accurate measurement of the immune response to tuberculosis antigens. The following steps outline the process:
After the procedure, the patient may be advised to follow up with their healthcare provider to discuss the results of the test. If the test is positive, further evaluation and treatment for tuberculosis may be necessary. It is important for healthcare professionals to monitor the patient for any symptoms of TB and to provide appropriate care based on the test results. Additionally, the patient should be informed about the significance of the test results and any further steps that may be required, including potential isolation or additional testing.
| Short Descr | TB AG RESPONSE T-CELL SUSP | Medium Descr | TB ANTIGEN RESPONSE GAMMA INTERFERON T-CELL SUSP | Long Descr | Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension | 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 | 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) | GW | Service not related to the hospice patient's terminal condition | 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. | 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. | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | 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 | 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 | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital |
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| 2011-01-01 | Added | Added |
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