CPT® Code 86787

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.