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The CPT® Code 86704 refers to the testing of a blood sample for the presence of hepatitis B core antibody (HBcAb), which is a critical marker in the diagnosis and management of hepatitis B virus (HBV) infections. Hepatitis B is a viral infection that leads to inflammation of the liver and can manifest in both acute and chronic forms. The core antibody is produced by the immune system during and after an acute HBV infection, and it can also be present during the chronic phase of the disease. This test measures the total HBcAb, which includes both IgG and IgM antibodies, using a chemiluminescent assay. It is important to note that this test does not differentiate between the two types of antibodies; therefore, it cannot specify whether the infection is in the acute or chronic phase. The presence of IgM antibodies typically indicates an initial phase of infection, while IgG antibodies are associated with later stages. For a more specific diagnosis of an acute infection, the CPT® Code 86705 is utilized, which specifically tests for the IgM antibody to HBcAb.
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The CPT® Code 86704 is indicated for the testing of individuals who may have been exposed to the hepatitis B virus (HBV) or who are exhibiting symptoms consistent with hepatitis B infection. The following conditions may warrant the use of this test:
The procedure for CPT® Code 86704 involves several key steps to ensure accurate testing for hepatitis B core antibody (HBcAb):
After the procedure associated with CPT® Code 86704, patients may not require any specific post-procedure care, as the blood draw is a routine procedure. However, it is important for healthcare providers to discuss the results with the patient once they are available. If the test results are positive, further evaluation may be necessary to determine the phase of the infection and appropriate management strategies. Patients should be informed about the potential need for additional testing, such as the specific IgM antibody test (CPT® Code 86705), to clarify the nature of the infection. Additionally, patients should be advised to monitor for any symptoms of hepatitis B and to follow up with their healthcare provider for ongoing care and management.
| Short Descr | HEP B CORE ANTIBODY TOTAL | Medium Descr | HEPATITIS B CORE ANTIBODY HBCAB TOTAL | Long Descr | Hepatitis B core antibody (HBcAb); total | 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 | 1 | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GZ | Item or service expected to be denied as not reasonable and necessary | Q4 | Service for ordering/referring physician qualifies as a service exemption | 33 | Preventive services: when the primary purpose of the service is the delivery of an evidence based service in accordance with a us preventive services task force a or b rating in effect and other preventive services identified in preventive services mandates (legislative or regulatory), the service may be identified by adding 33 to the procedure. for separately reported services specifically identified as preventive, the modifier should not be used. | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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. | 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 | 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. | 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 | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | KX | Requirements specified in the medical policy have been met | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | QW | Clia waived test | 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 |
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| 2011-01-01 | Changed | Short description changed. |
| 2001-01-01 | Changed | Code description changed. |
| 1998-01-01 | Added | First appearance in code book in 1998. |
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