CPT® Code 86720

Official Description

Antibody; Leptospira

Common Language Description

The CPT® Code 86720 refers to a laboratory test specifically designed to measure antibodies against Leptospira, a type of spirochete bacteria that can infect both humans and animals. This test is crucial for diagnosing leptospirosis, a disease that is primarily transmitted through direct contact with the mucous membranes of infected animals or through exposure to soil contaminated with the urine of chronic carrier animals. Individuals working in high-risk occupations, such as those in the farming, agriculture, fishing industries, veterinarians, pet shop employees, and slaughterhouse workers, are particularly susceptible to this infection. Additionally, recreational activities such as water sports and hiking can also pose a risk of exposure. Leptospirosis can present in two distinct forms: anicteric and icteric. The anicteric form is characterized by mild, self-limiting flu-like symptoms that can include sudden onset of headache, fever, muscle pain, sore throat, cough, conjunctivitis, and rash. In contrast, the icteric form, also known as Weil's disease, is more severe and can lead to serious complications such as fever, jaundice, renal failure, and hemorrhage, potentially affecting multiple organs including the heart, lungs, and central nervous system. To perform this test, a blood sample is collected through a procedure known as venipuncture, which is reported separately. The serum obtained from the blood is then analyzed for total antibodies using a semi-quantitative indirect hemagglutination method, as well as for IgM antibodies through qualitative immunoblot testing.

1. Indications

The CPT® Code 86720 is indicated for the detection of antibodies to Leptospira in patients who may be at risk for leptospirosis. The following conditions and situations warrant the use of this laboratory test:

Occupational Exposure: Individuals working in high-risk environments such as agriculture, veterinary medicine, pet shops, and slaughterhouses, where contact with infected animals or contaminated environments is likely.
Recreational Activities: Persons engaging in water sports, hiking, or other outdoor activities in areas where Leptospira may be present in the environment.
Clinical Symptoms: Patients presenting with symptoms consistent with leptospirosis, including fever, headache, muscle pain, and other flu-like symptoms, particularly if they have a history of potential exposure.

2. Procedure

The procedure for testing antibodies to Leptospira involves several key steps, which are outlined below:

Step 1: Patient Preparation - Prior to the blood draw, the patient may be instructed to avoid certain medications or activities that could interfere with the test results. It is essential to ensure that the patient is adequately informed about the procedure and its purpose.
Step 2: Venipuncture - A qualified healthcare professional performs venipuncture to obtain a blood sample. This involves using a sterile needle to access a vein, typically in the arm, and collecting the blood into a designated tube. The procedure is performed under aseptic conditions to minimize the risk of infection.
Step 3: Serum Separation - After collection, the blood sample is processed to separate the serum from the cellular components. This is typically done by centrifugation, which spins the sample at high speed to facilitate the separation of serum.
Step 4: Antibody Testing - The serum is then subjected to testing for total antibodies using a semi-quantitative indirect hemagglutination method. Additionally, IgM antibodies are assessed using qualitative immunoblot techniques. These methods help determine the presence and levels of antibodies against Leptospira.

3. Post-Procedure

After the procedure, the patient may experience minor discomfort or bruising at the venipuncture site, which typically resolves quickly. There are no specific post-procedure care instructions required for this test; however, patients should be advised to monitor the site for any signs of infection or excessive bleeding. The results of the antibody test will be interpreted by a healthcare provider, who will discuss the findings with the patient and determine any necessary follow-up actions based on the results and clinical context.

Short Descr	LEPTOSPIRA ANTIBODY
Medium Descr	ANTIBODY LEPTOSPIRA
Long Descr	Antibody; Leptospira
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

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.

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.