CPT® Code 86727

Official Description

Antibody; lymphocytic choriomeningitis

Common Language Description

The CPT® Code 86727 refers to a laboratory test specifically designed to detect antibodies against the lymphocytic choriomeningitis virus (LCMV) in blood and/or cerebrospinal fluid (CSF). LCMV is a virus belonging to the arenaviridae family and is primarily transmitted to humans through contact with the excretions of infected rodents, particularly house mice and potentially pet rodents like hamsters. The transmission occurs when individuals come into contact with fresh urine, droppings, saliva, or nesting materials of these rodents, with the virus entering the human body through broken skin, mucous membranes, or bites. It is important to note that LCMV is not transmitted from person to person; however, it can be passed to an unborn child through placental transfer during pregnancy. The clinical presentation of LCMV infection typically follows a biphasic pattern. The initial phase is characterized by symptoms such as fever, malaise, decreased appetite, headache, muscle pain, nausea, and vomiting. Following this, the second phase may involve central nervous system (CNS) symptoms, which can include fever, stiff neck, headache, drowsiness, confusion, and sensory-motor abnormalities. Importantly, the illness does not progress to a chronic state, and most patients recover fully once the virus is cleared from their system. A positive result from the LCMV antibody test indicates either a current or past infection. The testing process involves obtaining a blood sample through venipuncture, which is reported separately, and a CSF sample through a lumbar puncture, also reported separately. The laboratory tests for the presence of IgG and IgM antibodies using a semi-quantitative indirect fluorescent antibody method.

1. Indications

The antibody test for lymphocytic choriomeningitis (LCMV) is indicated for the following conditions:

Possible LCMV Infection Patients presenting with symptoms consistent with LCMV infection, such as fever, malaise, headache, and muscle pain, may require testing to confirm the presence of antibodies.
Neurological Symptoms Individuals exhibiting central nervous system symptoms, including confusion, drowsiness, or stiff neck, may be tested to determine if LCMV is the underlying cause.
Exposure History Patients with a known history of exposure to rodents or environments where LCMV is prevalent may be tested for antibodies to assess potential infection.
Pregnancy Monitoring Pregnant women who have been exposed to LCMV may be tested to evaluate the risk of transmission to the fetus.

2. Procedure

The procedure for testing antibodies to lymphocytic choriomeningitis virus involves several key steps:

Step 1: Patient Preparation The patient is prepared for the procedure, which may include explaining the test and obtaining informed consent. It is essential to ensure that the patient understands the purpose of the test and any potential risks associated with blood or CSF collection.
Step 2: Sample Collection A blood sample is obtained through venipuncture, which is a standard procedure where a needle is inserted into a vein, typically in the arm, to collect blood. This sample is crucial for testing IgG and IgM antibodies. If CSF testing is required, a lumbar puncture is performed to collect cerebrospinal fluid. This involves inserting a needle into the lower back to access the spinal canal, and it is also reported separately.
Step 3: Laboratory Testing The collected serum and CSF samples are sent to the laboratory for analysis. The laboratory employs a semi-quantitative indirect fluorescent antibody method to detect the presence of IgG and IgM antibodies specific to LCMV. This method allows for the determination of antibody levels, which can indicate current or past infection.
Step 4: Result Interpretation Once the laboratory analysis is complete, the results are interpreted by a qualified healthcare professional. A positive titer suggests that the patient has been exposed to LCMV, while negative results may indicate no current or past infection.

3. Post-Procedure

After the procedure, patients may experience mild discomfort at the venipuncture or lumbar puncture site, which typically resolves quickly. It is important for patients to be monitored for any adverse reactions, especially following a lumbar puncture, as there may be a risk of headache or other complications. Patients should be advised to rest and hydrate adequately after the procedure. The healthcare provider will discuss the results of the antibody test with the patient once they are available, and any necessary follow-up actions or treatments will be determined based on the findings.

Short Descr	LYMPH CHORIOMENINGITIS AB
Medium Descr	ANTIBODY LYMPHOCYTIC CHORIOMENINGITIS
Long Descr	Antibody; lymphocytic choriomeningitis
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

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
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