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The CPT® Code 86757 refers to the laboratory test for antibodies to Rickettsia, which are a group of bacteria known to cause various diseases in humans. This test involves analyzing a blood sample to detect the presence of antibodies that the immune system produces in response to an infection by Rickettsial organisms. In the United States, the primary Rickettsial species tested include Rickettsia rickettsii, which is responsible for Rocky Mountain spotted fever, and Rickettsia typhi, associated with typhus fever. Infection with R. rickettsii typically begins with symptoms such as fever, headache, fatigue, nausea, and muscle aches, which may progress to include a rash, abdominal pain, and joint pain. On the other hand, R. typhi can be transmitted through bites from infected lice, fleas, or mites, leading to an acute febrile illness. The testing methodologies commonly employed for detecting Rickettsia antibodies include Indirect Fluorescent Antibody (IFA) and Enzyme-Linked Immunosorbent Assay (ELISA). The test can measure two types of immunoglobulins: IgG, which indicates a current or past infection, and IgM, which is indicative of a current infection. It is important to note that if both IgG and IgM tests are conducted, each test should be reported separately to ensure accurate documentation and coding.
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The antibody test for Rickettsia, coded as CPT® 86757, is indicated for the following conditions:
The procedure for testing antibodies to Rickettsia involves several key steps, which are outlined below:
After the antibody testing for Rickettsia is completed, the patient may not require any specific post-procedure care. However, it is essential for healthcare providers to discuss the results with the patient, especially if the tests indicate a current or past infection. Follow-up care may be necessary depending on the clinical context and the patient's symptoms. Additionally, healthcare providers should ensure that the results are integrated into the patient's medical record for ongoing management and treatment considerations.
| Short Descr | RICKETTSIA ANTIBODY | Medium Descr | ANTIBODY RICKETTSIA | Long Descr | Antibody; Rickettsia | 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 | 6 | 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. | Q4 | Service for ordering/referring physician qualifies as a service exemption | 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. | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2001-01-01 | Added | First appearance in code book in 2001. |
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