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The CPT® Code 86709 refers to the testing of a blood sample for the presence of the hepatitis A antibody (HAAb), specifically the IgM antibody. Hepatitis A is an infectious disease characterized by acute inflammation of the liver, which is caused by the hepatitis A virus (HAV). During the acute phase of the infection, the liver experiences inflammation, but it typically heals completely without leading to chronic liver disease. Following recovery from hepatitis A, the patient develops lifelong immunity to the virus, which protects against future infections. The test associated with CPT® Code 86709 is specifically designed to detect the IgM antibody to HAAb, indicating a current, acute infection. This is in contrast to CPT® Code 86708, which tests for both IgG and IgM antibodies without differentiating between them and is primarily used to assess immunity following vaccination against hepatitis A. The specificity of the IgM test in CPT® Code 86709 makes it a crucial tool for diagnosing active hepatitis A infections.
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The CPT® Code 86709 is indicated for use in specific clinical scenarios where there is a suspicion of an acute hepatitis A infection. The following conditions warrant the performance of this test:
The procedure for testing under CPT® Code 86709 involves several key steps to ensure accurate results. The following outlines the procedural steps:
After the procedure associated with CPT® Code 86709, the patient may experience minimal discomfort at the site of blood collection. There are no specific post-procedure care requirements beyond standard care for venipuncture. Patients should be informed about the expected timeline for receiving test results, which typically varies based on laboratory processing times. If the test result is positive, further clinical evaluation and management will be necessary to address the acute hepatitis A infection, including monitoring for complications and providing supportive care as needed.
| Short Descr | HEPATITIS A IGM ANTIBODY | Medium Descr | HEPATITIS ANTIBODY HAAB IGM ANTIBODY | Long Descr | Hepatitis A antibody (HAAb), IgM antibody | 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. | GZ | Item or service expected to be denied as not reasonable and necessary | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | 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. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | 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 | 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 |
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| 2016-01-01 | Changed | Description Changed |
| 2013-01-01 | Changed | Short Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| 1998-01-01 | Added | First appearance in code book in 1998. |
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