CPT® Code 86658

The CPT® Code 86658 refers to a laboratory test that measures antibodies specific to enteroviruses, which include coxsackievirus, echovirus, and poliovirus. These viruses belong to the picornaviridae family and are known for their role in various infectious diseases. The test is performed on serum and/or cerebrospinal fluid (CSF) to assess the presence of antibodies that indicate an immune response to these viruses. Coxsackievirus is categorized into two groups, A and B, with multiple subtypes that can lead to a range of clinical manifestations. For instance, Coxsackievirus A is associated with herpangina and hand, foot, and mouth disease, while Coxsackievirus B is linked to more severe conditions such as epidemic pleurodynia, which presents with fever and pain. Echovirus infections can result in febrile illnesses and have been associated with meningitis and myositis. Poliovirus, known for its high infectivity, can lead to serious complications including paralysis. The testing process involves obtaining a blood sample through venipuncture and a CSF sample via lumbar puncture, both of which are reported separately. The CSF is analyzed for Coxsackievirus A and B and echovirus using complement fixation, while serum is evaluated for Coxsackievirus B, echovirus, and poliovirus through semi-quantitative serum neutralization. It is important to note that cross-reactivity among these enteroviruses may occur, and the virus with the highest titer is typically indicative of the infecting serotype.