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Official Description

Antibody; enterovirus (eg, coxsackie, echo, polio)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

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.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 86658 is indicated for the evaluation of suspected enterovirus infections. The following conditions may warrant this laboratory test:

  • Suspected Coxsackievirus Infection Symptoms may include herpangina, hand, foot, and mouth disease, conjunctivitis, or other manifestations related to Coxsackievirus A and B.
  • Suspected Echovirus Infection This may present as an acute febrile illness, potentially accompanied by a skin rash, and may lead to complications such as meningitis or myositis.
  • Suspected Poliovirus Infection Indications include gastrointestinal symptoms, fever, headache, sore throat, and neurological symptoms that may progress to muscle pain, spasms, or paralysis.

2. Procedure

The procedure for CPT® Code 86658 involves several key steps to ensure accurate measurement of enterovirus antibodies:

  • Step 1: Sample Collection A blood sample is obtained through venipuncture, which is a standard procedure for drawing blood. Additionally, cerebrospinal fluid (CSF) is collected via lumbar puncture, a procedure that involves inserting a needle into the lower back to access the spinal canal. Both samples are essential for the subsequent testing of antibodies.
  • Step 2: Testing of Cerebrospinal Fluid The CSF sample is tested for the presence of Coxsackievirus A and B and echovirus using a method known as complement fixation. This technique helps to identify the specific antibodies present in the CSF, which can indicate an active infection.
  • Step 3: Testing of Serum The serum sample is analyzed for antibodies against Coxsackievirus B, echovirus, and poliovirus using semi-quantitative serum neutralization. This method assesses the ability of the serum to neutralize the viruses, providing insight into the immune response of the patient.
  • Step 4: Interpretation of Results The results from both the CSF and serum tests are compared to determine antibody ratios. Cross-reactivity among the enteroviruses may occur, and the virus with the highest titer in the serum typically indicates the infecting serotype.

3. Post-Procedure

After the procedure, patients may experience mild discomfort at the venipuncture or lumbar puncture sites. It is important to monitor for any adverse reactions, particularly following the lumbar puncture, which may include headache or back pain. The results of the antibody tests will be reviewed by the healthcare provider to determine the appropriate clinical management based on the presence of enterovirus antibodies. Follow-up may be necessary to discuss the findings and any further diagnostic or therapeutic steps that may be required.

Short Descr ENTEROVIRUS ANTIBODY
Medium Descr ANTIBODY ENTEROVIRUS
Long Descr Antibody; enterovirus (eg, coxsackie, echo, polio)
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 12
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.
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.
Date
Action
Notes
1993-01-01 Added First appearance in code book in 1993.
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