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The CPT® Code 86665 refers to a laboratory test that measures antibodies against the Epstein-Barr virus (EBV), specifically targeting the viral capsid antigen (VCA). This test is crucial for diagnosing infections caused by EBV, which is known to lead to infectious mononucleosis, a common viral illness primarily affecting children and young adults. Infectious mononucleosis is typically characterized by a range of symptoms including fever, fatigue, sore throat, swollen lymph nodes, and in some cases, an enlarged spleen. The transmission of EBV occurs through saliva, particularly during active infection, and the virus can persist in the body’s lymphocytes for life, with potential reactivation occurring without noticeable symptoms. In addition to infectious mononucleosis, EBV is associated with several serious conditions, including X-linked lymphoproliferative syndrome in males and various malignancies such as Burkitt lymphoma, Hodgkin's lymphoma, and nasopharyngeal carcinoma. The antibody tests related to EBV, including the early antigen (EA) IgG antibody test (CPT® Code 86663) and the EBV nuclear antigen (EBNA) IgG antibody test (CPT® Code 86664), are utilized to provide a comprehensive understanding of a patient's exposure to the virus and the status of their immune response. The VCA test for IgG and IgM antibodies, represented by CPT® Code 86665, is particularly valuable for diagnosing primary EBV infectious mononucleosis when used in conjunction with other diagnostic tests. However, it is important to note that the VCA test for IgA antibodies is not suitable for diagnosing infectious mononucleosis but may assist in the detection and prognosis of nasopharyngeal carcinoma. The testing process involves obtaining a blood sample through venipuncture, and the serum is analyzed using a semi-quantitative chemiluminescent immunoassay, ensuring accurate measurement of the antibodies present.
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The CPT® Code 86665 is indicated for use in the following scenarios:
The procedure for conducting the test associated with CPT® Code 86665 involves several key steps:
After the procedure, patients may experience minimal discomfort 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 report any unusual symptoms or prolonged discomfort. The results of the test will be communicated to the ordering physician, who will interpret the findings in the context of the patient's clinical presentation and history. Follow-up testing or additional diagnostic procedures may be recommended based on the results obtained from the EBV antibody testing.
| Short Descr | EPSTEIN-BARR CAPSID VCA | Medium Descr | ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA | Long Descr | Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) | 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 |
| 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. | 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. | 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. | 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | 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 | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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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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