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The CPT® Code 86664 refers to a laboratory test that measures antibodies against the Epstein-Barr virus (EBV), specifically targeting the nuclear antigen (EBNA). This test is significant in the context of infectious mononucleosis, a viral infection commonly affecting children and young adults. The symptoms of this condition typically include fever, fatigue, sore throat, swollen lymph nodes, and in some cases, an enlarged spleen. The Epstein-Barr virus is primarily transmitted through saliva, particularly during active infection, and it has the ability to persist in the body’s lymphocytes for the lifetime of the individual, occasionally reactivating without presenting any symptoms. In addition to causing infectious mononucleosis, EBV is associated with several serious health conditions, including X-linked lymphoproliferative syndrome in males and various types of cancers such as Burkitt lymphoma, Hodgkin's lymphoma, and nasopharyngeal carcinoma. The EBNA IgG antibody test, represented by CPT® Code 86664, is utilized to document past exposure to EBV and can assist in diagnosing primary EBV infectious mononucleosis when used alongside other serological tests. It is important to note that while the early antigen (EA) IgG antibody test (CPT® Code 86663) is helpful in diagnosing acute EBV infections or reactivations, it should not be used in isolation for diagnosis. Furthermore, the EBV viral capsid antigen (VCA) test (CPT® Code 86665) evaluates IgG and IgM antibodies and is also relevant in the diagnostic process. However, the VCA test for IgA antibodies is not suitable for diagnosing infectious mononucleosis but may provide insights into the detection and prognosis of nasopharyngeal carcinoma. The blood sample required for this test is obtained through a venipuncture, and the serum is analyzed using a semi-quantitative chemiluminescent immunoassay method.
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The EBV nuclear antigen (EBNA) IgG antibody test, represented by CPT® Code 86664, is indicated for the following conditions:
The procedure for conducting the EBV nuclear antigen (EBNA) IgG antibody test involves several key steps:
Post-procedure care for the patient is generally minimal following the venipuncture. Patients may be advised to apply pressure to the site of the blood draw to minimize bruising and bleeding. They should also be informed about potential minor side effects, such as soreness or bruising at the puncture site. The results of the EBNA IgG antibody test will typically be reviewed by the healthcare provider, who will interpret the findings in the context of the patient's clinical presentation and other diagnostic tests. Follow-up appointments may be scheduled to discuss the results and any necessary further actions based on the findings.
| Short Descr | EPSTEIN-BARR NUCLEAR ANTIGEN | Medium Descr | ANTIBODY EPSTEIN-BARR EB VIRUS NUCLEAR AG EBNA | Long Descr | Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) | 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. | 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. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q4 | Service for ordering/referring physician qualifies as a service exemption | 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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| 2013-01-01 | Changed | Short Descriptor changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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