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The CPT® Code 86780 refers to an antibody test specifically for Treponema pallidum, which is the bacterium responsible for causing syphilis, a sexually transmitted disease (STD). This test is crucial for diagnosing syphilis and is performed using various techniques, including fluorescent treponemal antibody absorption (FTA-ABS), T. pallidum particle agglutination (TP-PA), or indirect fluorescent antibody (IFA). Syphilis progresses through several stages, starting with the primary stage where a sore known as a chancre appears at the entry point of the bacterium. Although this sore typically resolves on its own within three to six weeks, the infection persists if left untreated, leading to further complications. In the secondary stage, patients may experience a range of symptoms, including a distinctive skin rash and mucous membrane lesions, particularly on the palms and soles. Other systemic symptoms can include fever, swollen lymph nodes, sore throat, hair loss, headaches, weight loss, muscle aches, and fatigue. These symptoms may also resolve spontaneously, but the infection remains active. If untreated, the disease can progress to a late or latent stage, which may not manifest symptoms for a decade or two. Late-stage syphilis can result in severe complications, such as coordination difficulties, paralysis, numbness, gradual blindness, and dementia, as the infection damages vital organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. A significant concern is the transmission of syphilis from an infected mother to her baby during pregnancy, which can lead to stillbirth or severe health issues in the newborn, including developmental delays or seizures. The FTA-ABS and IFA tests can be conducted on blood or cerebrospinal fluid (CSF) samples, while the TP-PA test is limited to blood samples only.
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The antibody test for Treponema pallidum (CPT® Code 86780) is indicated for the diagnosis of syphilis, particularly in the following scenarios:
The procedure for conducting the antibody test for Treponema pallidum involves several key steps:
After the antibody test for Treponema pallidum is completed, patients may not require any specific post-procedure care. However, it is essential for healthcare providers to follow up with patients regarding their test results. If the test is positive, further evaluation and treatment options should be discussed, including potential referral to a specialist for management of syphilis. Patients should also be educated about the importance of notifying sexual partners and the need for follow-up testing to monitor the infection and treatment response. In cases where the test is negative but clinical suspicion remains, additional testing or alternative diagnostic methods may be warranted.
| Short Descr | TREPONEMA PALLIDUM | Medium Descr | ANTIBODY TREPONEMA PALLIDUM | Long Descr | Antibody; Treponema pallidum | 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) | Yes | APC Status Indicator | Service Paid under Fee Schedule or Payment System other than OPPS | 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. | QW | Clia waived test | GZ | Item or service expected to be denied as not reasonable and necessary | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | 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. | 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. | Q4 | Service for ordering/referring physician qualifies as a service exemption | 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 | 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 33 | Preventive services: when the primary purpose of the service is the delivery of an evidence based service in accordance with a us preventive services task force a or b rating in effect and other preventive services identified in preventive services mandates (legislative or regulatory), the service may be identified by adding 33 to the procedure. for separately reported services specifically identified as preventive, the modifier should not be used. | 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. | 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. | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | FP | Service provided as part of family planning program | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | KX | Requirements specified in the medical policy have been met | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2011-01-01 | Changed | Short description changed. |
| 2010-01-01 | Added | - |
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