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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.
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The antibody test for Francisella tularensis (CPT® Code 86668) is indicated for the following conditions:
The procedure for conducting the Francisella tularensis antibody test involves several key steps:
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 |
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| 2004-01-01 | Changed | Code description changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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