Coding Ahead
CasePilot
Medical Coding Assistant
Case2Code
Search and Code Lookup Tool
CareerCenter
Medical Coding Job Board
Log in Register free account

Need help choosing the right code?

Ask CasePilot about procedures, modifiers, bundling, and coding guidance.

Try CasePilot

Official Description

Antibody; varicella-zoster

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 86787 refers to a laboratory test specifically designed to measure antibodies against the varicella-zoster virus (VZV) in blood and/or cerebrospinal fluid (CSF). The varicella-zoster virus is primarily transmitted through respiratory droplets and can enter the body via the nose, mouth, or conjunctiva. Upon initial infection, the virus causes chickenpox, which is characterized by symptoms such as fever, malaise, and a distinctive itchy macular rash. This rash progresses through various stages, starting as macules, evolving into papules, and ultimately forming vesicular lesions that crust and scab over as the infection resolves. After the primary infection, the varicella-zoster virus can enter a dormant phase within sensory nerve ganglia, where it may remain inactive for an extended period. This dormant virus can reactivate later in life, leading to shingles, a condition marked by skin paresthesia, pain, and a unilateral vesicular eruption that typically follows the distribution of sensory nerves, particularly in the trunk or along the 5th cranial nerve. The laboratory test for varicella-zoster antibodies involves measuring two types of antibodies: IgM and IgG. A positive IgM antibody titer indicates a current or recent infection; however, it is important to note that IgM antibodies may remain elevated for more than 12 months following the initial infection. Conversely, a positive IgG antibody titer suggests either a current or past infection with the varicella-zoster virus. The testing process requires a blood sample, which is obtained through a separately reportable venipuncture, and a CSF sample, which is collected via a separately reportable lumbar puncture. The laboratory employs semi-quantitative enzyme-linked immunosorbent assay (ELISA) to test for IgM antibodies and semi-quantitative chemiluminescent immunoassay for IgG antibodies.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The varicella-zoster antibody test (CPT® Code 86787) is indicated for the following conditions:

  • Diagnosis of Chickenpox: The test is performed to confirm a current or recent infection of chickenpox in patients presenting with characteristic symptoms such as fever, malaise, and a macular rash.
  • Diagnosis of Shingles: It is utilized to assess the presence of varicella-zoster antibodies in patients exhibiting symptoms of shingles, including skin paresthesia, pain, and vesicular eruptions along sensory nerves.
  • Assessment of Immunity: The test may be conducted to determine immunity status in individuals who have had previous exposure to the varicella-zoster virus or have been vaccinated against it.
  • Monitoring of Immunocompromised Patients: It is indicated for monitoring varicella-zoster antibody levels in immunocompromised patients who may be at risk for reactivation of the virus.

2. Procedure

The procedure for testing varicella-zoster antibodies involves several key steps, which are outlined below:

  • Step 1: Patient Preparation The patient is prepared for the blood draw or lumbar puncture, ensuring that they are informed about the procedure and any necessary pre-test instructions are followed.
  • Step 2: Sample Collection A blood sample is obtained through venipuncture, which is a separately reportable procedure. If cerebrospinal fluid (CSF) is required, a lumbar puncture is performed to collect the CSF sample, which is also reportable separately.
  • Step 3: Laboratory Testing The collected serum and CSF samples are sent to the laboratory for analysis. The laboratory employs a semi-quantitative enzyme-linked immunosorbent assay (ELISA) to test for IgM antibodies and a semi-quantitative chemiluminescent immunoassay to test for IgG antibodies against the varicella-zoster virus.
  • Step 4: Result Interpretation The laboratory interprets the results, providing information on the presence of IgM and IgG antibodies, which helps in determining the patient's infection status and immunity to the varicella-zoster virus.

3. Post-Procedure

After the procedure, patients may experience mild discomfort or bruising at the venipuncture site or lumbar puncture site. It is important to monitor for any signs of complications, such as infection or excessive bleeding. Patients should be advised to rest and hydrate adequately following the procedure. The results of the antibody tests will typically be available within a specified timeframe, and healthcare providers will discuss the findings with the patient to determine any necessary follow-up actions based on the results.

Short Descr VARICELLA-ZOSTER ANTIBODY
Medium Descr ANTIBODY VARICELLA-ZOSTER
Long Descr Antibody; varicella-zoster
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.
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.
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)
Q4 Service for ordering/referring physician qualifies as a service exemption
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.
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.
AY Item or service furnished to an esrd patient that is not for the treatment of esrd
GA Waiver of liability statement issued as required by payer policy, individual case
GW Service not related to the hospice patient's terminal condition
GX Notice of liability issued, voluntary under payer policy
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
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
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
Date
Action
Notes
1993-01-01 Added First appearance in code book in 1993.
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"