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Official Description

Antibody; Francisella tularensis

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 86668 refers to a laboratory test specifically designed to measure antibodies against Francisella tularensis, the bacterium responsible for tularemia. This test is crucial for diagnosing infections caused by F. tularensis, which is prevalent throughout the continental United States and can affect both humans and animals. The bacterium can be transmitted through various routes, including bites from ticks and deer flies, direct skin contact with infected animals, ingestion of contaminated water, inhalation of contaminated dust, or exposure in laboratory settings. Symptoms of tularemia can manifest in several ways, including the development of skin ulcers, swollen lymph nodes, sore throat, mouth sores resulting from oral contact, and pneumonia associated with inhalation of the bacteria. The test measures two types of antibodies: IgG and IgM. Elevated levels of IgG antibodies may suggest either a current or past infection, while increased IgM levels are more indicative of a recent or ongoing infection. To perform this test, a blood sample is collected, typically through a venipuncture, which is a separately reportable procedure. The serum or plasma obtained from the blood sample is then analyzed using a semi-quantitative enzyme-linked immunosorbent assay (ELISA) method. It is important to note that there may be cross-reactivity with antibodies from other infections, such as those caused by Brucella, Yersinia, and Proteus OX19, which can complicate the interpretation of results.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The antibody test for Francisella tularensis (CPT® Code 86668) is indicated for the following conditions:

  • Suspected Tularemia Infection This test is performed when there is a clinical suspicion of tularemia, particularly in patients presenting with symptoms such as skin ulcers, swollen lymph nodes, sore throat, mouth sores, or pneumonia.
  • Exposure History The test is indicated for individuals who have a known exposure to F. tularensis, such as those who have been bitten by ticks or deer flies, had contact with infected animals, or have been in environments where the bacterium may be present.
  • Monitoring of Antibody Response The test may be used to monitor the antibody response in patients who have been previously diagnosed with tularemia, helping to determine if there has been a recent or past infection.

2. Procedure

The procedure for conducting the Francisella tularensis antibody test involves several key steps:

  • Step 1: Patient Preparation Prior to the test, the patient may be instructed to avoid certain medications or activities that could affect the results. However, specific preparation guidelines should be followed as per the laboratory's protocols.
  • Step 2: Venipuncture A qualified healthcare professional performs a venipuncture to obtain a blood sample from the patient. This involves using a sterile needle to access a vein, typically in the arm, and collecting the blood into a designated tube. This step is crucial as the blood sample will be used for the subsequent analysis of antibodies.
  • Step 3: Sample Processing Once the blood sample is collected, it is processed to separate the serum or plasma from the cellular components. This is typically done through centrifugation, which allows for the clear serum or plasma to be obtained for testing.
  • Step 4: Laboratory Analysis The serum or plasma is then subjected to a semi-quantitative enzyme-linked immunosorbent assay (ELISA) to detect and measure the levels of IgG and IgM antibodies specific to Francisella tularensis. This assay provides valuable information regarding the patient's exposure to the bacterium.

3. Post-Procedure

After the procedure, the patient may experience minor discomfort or bruising at the venipuncture site, which typically resolves quickly. The laboratory will analyze the sample and report the results, which may take several days. It is important for healthcare providers to interpret the results in conjunction with clinical findings and patient history, as elevated antibody levels can indicate current or past infections and may require further clinical evaluation or treatment. Additionally, healthcare professionals should be aware of the potential for cross-reactivity with antibodies from other infections, which may influence the interpretation of the test results.

Short Descr FRANCISELLA TULARENSIS
Medium Descr ANTIBODY FRANCISELLA TULARENSIS
Long Descr Antibody; Francisella tularensis
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.
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.
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
Q4 Service for ordering/referring physician qualifies as a service exemption
Date
Action
Notes
2004-01-01 Changed Code description changed.
1993-01-01 Added First appearance in code book in 1993.
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Description
Code
Description
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