CPT® Code 86804

The CPT® Code 86804 refers to a confirmatory test for Hepatitis C antibodies, specifically utilizing methods such as the immunoblot technique. This laboratory test is crucial for accurately diagnosing Hepatitis C virus (HCV) infections, which can lead to significant liver inflammation, either in an acute or chronic form. Hepatitis C is primarily transmitted through blood, making it a concern in various scenarios, including blood transfusions, needle stick injuries, and the sharing of needles, particularly in both occupational settings and among individuals using recreational drugs. Additionally, the virus can be spread through unprotected sexual contact, from mother to child during pregnancy, or through the sharing of personal items that may come into contact with blood, such as razors or toothbrushes. The confirmatory test represented by CPT® Code 86804 is performed following an initial screening test, which is reported under CPT® Code 86803. The screening test is designed to identify individuals who are at risk for HCV infection. A blood sample is collected through a procedure known as venipuncture, which is separately reportable. The serum obtained from the blood sample is then analyzed using a qualitative chemiluminescent immunoassay to detect the presence of antibodies against HCV. It is important to note that antibodies may not be detectable until approximately two months post-exposure, which necessitates retesting in cases where there is a strong clinical suspicion of HCV infection despite a negative initial screening result. If the screening test yields a positive result, it is essential to confirm this finding with the more specific test coded as 86804, which employs the recombinant immunoblot assay to ensure accurate diagnosis.