Need help choosing the right code?
Ask CasePilot about procedures, modifiers, bundling, and coding guidance.
Try CasePilot© Copyright 2026 American Medical Association. All rights reserved.
The CPT® Code 86619 refers to a laboratory test specifically designed to measure antibodies against Borrelia, the bacteria responsible for relapsing fever. This condition can be caused by two types of Borrelia spirochetes: those transmitted by ticks, known as tick-borne relapsing fever (TBRF), and those transmitted by lice, referred to as louse-borne relapsing fever (LBRF). TBRF is predominantly found in the western regions of the United States, particularly in mountainous areas that are infested with rodents, which serve as reservoirs for the disease. In contrast, LBRF is typically associated with refugee populations in underdeveloped regions of the world, where conditions may facilitate the spread of lice. Relapsing fever is characterized by a series of symptoms that include fever, chills, headache, muscle and joint pain, nausea, and potentially a rash. The onset of these symptoms usually occurs between 5 to 15 days following a tick or louse bite, and the symptoms can persist for a duration of 2 to 9 days. After an initial phase of symptoms, there may be a spontaneous remission, but the cycle of symptoms can recur until the patient receives appropriate antibiotic treatment. To perform this test, a blood sample is collected, which is reported separately through a venipuncture procedure. The serum obtained from the blood sample is then analyzed using a semi-quantitative immunofluorescence assay or an indirect fluorescent antibody technique, allowing for the detection of antibodies specific to Borrelia.
© Copyright 2026 Coding Ahead. All rights reserved.
The laboratory test represented by CPT® Code 86619 is indicated for the detection of antibodies to Borrelia, which is essential in diagnosing relapsing fever. The following conditions and symptoms may warrant the use of this test:
The procedure for conducting the antibody test for Borrelia involves several key steps, which are outlined below:
After the procedure, the patient may experience minor discomfort or bruising at the venipuncture site, which typically resolves quickly. There are no specific post-procedure care instructions required for this test, but patients should be advised to monitor the site for any signs of infection or excessive bleeding. The results of the antibody test will be interpreted by a healthcare professional, who will discuss the findings with the patient and determine any necessary follow-up actions or treatments based on the results.
| Short Descr | BORRELIA ANTIBODY | Medium Descr | ANTIBODY BORRELIA RELAPSING FEVER | Long Descr | Antibody; Borrelia (relapsing fever) | 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. | 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. |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 1993-01-01 | Added | First appearance in code book in 1993. |
Get instant expert-level medical coding assistance.