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The CPT® Code 86698 refers to a laboratory test specifically designed to measure antibodies against Histoplasma, a type of fungus, in serum and/or cerebrospinal fluid (CSF). Histoplasma capsulatum is the most common species associated with human infections and is typically found in soil contaminated by bird or bat droppings. When the fungal spores are inhaled, they can lead to an infection that is often asymptomatic and self-limiting, particularly in healthy individuals. However, in vulnerable populations such as young children or those with compromised immune systems, the infection can escalate to more severe conditions, including chronic cavitary pulmonary disease, disseminated histoplasmosis, or meningitis. Common symptoms associated with this infection may include fever, chest pain, a dry cough, and joint pain. To perform this test, a blood sample is collected through a procedure known as venipuncture, which is reported separately. If CSF is required for testing, it is obtained via a lumbar puncture, which is also reported separately. The testing methods for serum may involve qualitative immunodiffusion, while both serum and CSF can be analyzed using semi-quantitative complement fixation techniques.
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The antibody test for Histoplasma (CPT® Code 86698) is indicated for the following conditions:
The procedure for testing Histoplasma antibodies involves several key steps, which are outlined below:
After the procedure, patients may experience mild discomfort at the venipuncture or lumbar puncture site, which typically resolves quickly. It is important for healthcare providers to monitor patients for any adverse reactions following the lumbar puncture, such as headache or back pain. The results of the Histoplasma antibody test will be interpreted by a qualified healthcare professional, who will consider the patient's clinical history and symptoms to determine the appropriate course of action based on the findings.
| Short Descr | HISTOPLASMA ANTIBODY | Medium Descr | ANTIBODY HISTOPLASMA | Long Descr | Antibody; histoplasma | 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 | 3 | 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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. | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary |
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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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