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The CPT® Code 86611 refers to the laboratory test for antibodies to Bartonella, a genus of bacteria known to cause various clinical manifestations in humans. This test is crucial for diagnosing infections caused by Bartonella species, particularly in patients presenting with symptoms such as fever, chills, headaches, and progressive anemia during the acute phase of the infection. In chronic cases, patients may experience musculoskeletal pain and skin lesions, which can also affect mucous membranes. The most prevalent species in the United States is Bartonella henselae, which is notably associated with cat-scratch disease, a localized infection characterized by fever, headache, loss of appetite, and swollen lymph nodes. In immunocompromised individuals, such as those with HIV, B. henselae can lead to skin lesions that may resemble Kaposi's sarcoma. The infection can also have severe neurological implications, including meningoencephalitis, which may result in seizures, paralysis, and potentially fatal outcomes. Various testing methodologies are employed to detect Bartonella infections, including indirect hemagglutination (IHA), indirect fluorescent antibody (IFA), and enzyme-linked immunosorbent assay (ELISA). The test distinguishes between immunoglobulin classes, with IgG testing indicating past or current infections and IgM testing specifically identifying current infections. It is important to report the results of IgG and IgM tests separately when both are conducted, ensuring accurate diagnosis and management of the infection.
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The antibody test for Bartonella (CPT® Code 86611) is indicated for patients who present with a variety of symptoms that may suggest a Bartonella infection. These indications include:
The procedure for testing antibodies to Bartonella involves several key steps to ensure accurate results. The process begins with the collection of a blood sample from the patient, which is essential for the subsequent analysis. This sample is then processed in a laboratory setting where various testing methodologies may be employed. The most common methods include indirect hemagglutination (IHA), indirect fluorescent antibody (IFA), and enzyme-linked immunosorbent assay (ELISA). Each of these techniques is designed to detect the presence of specific antibodies in the blood that indicate either a current or past infection with Bartonella species. For instance, IgG testing is utilized to identify antibodies that suggest a previous exposure or ongoing infection, while IgM testing is specifically aimed at detecting antibodies that indicate a current infection. It is important to note that if both IgG and IgM tests are performed, the results for each immunoglobulin class must be reported separately to provide a comprehensive understanding of the patient's immune response to the infection.
After the antibody testing for Bartonella is completed, the patient may not require any specific post-procedure care, as the blood draw is a routine procedure. However, it is essential for healthcare providers to communicate the results to the patient promptly. Depending on the test outcomes, further clinical evaluation and management may be necessary. If the test indicates a current infection, appropriate treatment options should be discussed with the patient, which may include antibiotics or other supportive measures. Additionally, patients should be advised to monitor for any worsening symptoms and to follow up with their healthcare provider for further assessment and management of their condition.
| Short Descr | BARTONELLA ANTIBODY | Medium Descr | ANTIBODY BARTONELLA | Long Descr | Antibody; Bartonella | 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 | 4 | 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. | 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. | 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 | 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. | 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. | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 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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| 2001-01-01 | Added | First appearance in code book in 2001. |
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