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The CPT® Code 86617 refers to a laboratory test specifically designed to confirm the presence of antibodies against Borrelia burgdorferi, the bacterium responsible for Lyme disease. This confirmatory test is typically performed when a patient exhibits symptoms indicative of Lyme disease and has previously undergone an ELISA (Enzyme-Linked Immunosorbent Assay) test that returned positive or equivocal results for B. burgdorferi antibodies. The test is crucial for accurate diagnosis, as it helps differentiate between active infection and past exposure to the bacterium. The presence of IgM antibodies, which typically begin to rise 2-3 weeks post-exposure, indicates a recent infection, reaching peak levels around 6 weeks before gradually declining. Conversely, IgG antibodies, which may take several weeks to become detectable, can remain elevated for an extended period, sometimes lasting for years after the initial infection. The testing process involves obtaining a blood sample through venipuncture or cerebrospinal fluid (CSF) via lumbar puncture, both of which are separately reportable procedures. The analysis of serum and CSF samples is conducted using quantitative methods such as the western blot or immunoblot techniques, which provide a detailed assessment of antibody levels and confirm the diagnosis of Lyme disease.
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The antibody test for Borrelia burgdorferi is indicated in specific clinical scenarios where Lyme disease is suspected. The following conditions warrant the performance of this confirmatory test:
The procedure for conducting the confirmatory test for Borrelia burgdorferi involves several key steps, which are outlined below:
Post-procedure care primarily involves monitoring the patient for any immediate complications related to the venipuncture or lumbar puncture, such as bleeding or infection at the site of the procedure. Patients may be advised to rest and hydrate adequately after the lumbar puncture, as this can help alleviate any potential headache that may occur as a side effect. Additionally, the healthcare provider will discuss the timeline for receiving test results and any necessary follow-up actions based on the findings of the antibody test. It is important for patients to understand that the presence of antibodies does not necessarily indicate an active infection, and further clinical correlation may be required.
| Short Descr | LYME DISEASE ANTIBODY | Medium Descr | ANTIBODY BORRELIA BURGDORFERI CONFIRMATORY TST | Long Descr | Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) | 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 | 2 | 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. | 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. | 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. | 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 | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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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| 2004-01-01 | Changed | Code description changed. |
| 1995-01-01 | Added | First appearance in code book in 1995. |
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