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The CPT® Code 86713 refers to a laboratory test specifically designed to measure antibodies against Legionella, a type of bacteria that can cause pneumonia and flu-like illnesses in humans. Legionella is commonly found in various environmental sources, particularly in water systems such as hot tubs, hot water tanks, swamp coolers, large plumbing systems, and decorative fountains. The presence of this bacteria can lead to serious health issues when individuals inhale mist or vapor that contains it. The test identifies six different serotypes of Legionella antibodies, with Type 1 being the most prevalent and frequently tested in clinical settings. For a comprehensive assessment, both IgM and IgG antibodies are measured, as they develop simultaneously during an infection. The IgM antibodies typically remain elevated as long as the IgG response is active, making it essential to test for both to ensure accurate clinical interpretation of the patient's immune response. The procedure involves obtaining a blood sample through venipuncture, which is reported separately, and the serum is then analyzed using a semi-quantitative indirect fluorescent antibody method to determine the presence and levels of these antibodies.
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The laboratory test coded as CPT® 86713 is indicated for the following conditions:
The procedure for conducting the Legionella antibody test involves several key steps:
After the procedure, the patient may be advised to monitor for any adverse reactions at the venipuncture site, such as swelling or bruising. There are no specific post-procedure care instructions provided in the data, but it is generally recommended that patients maintain hydration and follow up with their healthcare provider to discuss the test results and any necessary further actions based on the findings. The expected recovery from the venipuncture is typically quick, with most patients resuming normal activities shortly after the blood draw.
| Short Descr | LEGIONELLA ANTIBODY | Medium Descr | ANTIBODY LEGIONELLA | Long Descr | Antibody; Legionella | 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. | 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. | 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. | 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 |
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| 1993-01-01 | Added | First appearance in code book in 1993. |
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