Summary & Overview

CPT 86001: Allergen-specific Immunoglobulin G (IgG) Test

CPT code 86001 represents the laboratory technical procedure for detecting allergen-specific Immunoglobulin G (IgG), with results reported as quantitative or semiquantitative and billed per allergen. This code matters nationally because immunologic testing for allergen-specific antibodies is commonly used in diagnostic workflows and research contexts, and accurate coding affects laboratory billing, quality measurement, and claims processing. Key payers typically involved in coverage and reimbursement considerations include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn what CPT code 86001 represents, the clinical and operational context for ordering and performing the test, and the scope of the analysis: benchmark considerations, coding guidance, and relevant clinical context for laboratory immunoassays. Data not available in the input for payer-specific rates, associated taxonomies, ICD-10 diagnoses, and related codes.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 86001allergen-specific IgGlaboratory testingimmunologydiagnostic immunoassaystechnical componentper-allergen billingclinical laboratorylab codingmedical billing

Billing Code Overview

CPT code 86001 describes a laboratory technical procedure in which a lab analyst performs testing to detect the presence of allergen-specific Immunoglobulin G (IgG). The result produced by this technical test can be quantitative or semiquantitative, and the code is reported once per allergen tested.

Service type: Laboratory diagnostic testing (technical component)
Typical site of service: Clinical laboratory or hospital laboratory performing diagnostic immunoassays

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Clinical & Coding Specifications

Clinical Context

A 45-year-old patient presents to an outpatient allergy clinic with persistent gastrointestinal symptoms and suspected food-related immune responses after elimination diets and trial therapies. The clinician orders targeted allergen-specific immunoglobulin G testing to measure IgG antibodies to a panel of food proteins to help inform dietary management and identify potential delayed-type hypersensitivity patterns. The patient visit includes a focused history of symptom triggers, collection of a peripheral blood specimen by a phlebotomist, and laboratory submission. In the laboratory, a certified medical technologist or lab analyst performs the technical assay for allergen-specific IgG; each allergen tested is billed as one unit of 86001. Results are reported as quantitative or semiquantitative values and returned to the ordering clinician for interpretation in the context of the clinical history.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting the physician interpretation component separately from the laboratory technical component if applicable and billable.
`TC`	Technical component	Use when billing only the laboratory technical component performed by the lab for `86001`.
`59`	Distinct procedural service	Use when `86001` is performed in a distinct session or for a different allergen panel on the same day separate from other billed services.
`90`	Reference (outside) laboratory	Use when the specimen is sent to an outside reference laboratory and only the submitting facility bills for coordination.
`91`	Repeat clinical diagnostic lab test	Use when the same `86001` test is repeated on the same day to obtain another result.
`52`	Reduced services	Use when the lab procedure is partially reduced or not completed as originally described.
`53`	Discontinued procedure	Use when testing is started but discontinued for clinical reasons prior to completion.
`76`	Repeat procedure by same physician	Use when the same provider repeats `86001` for the same patient later the same day (Note: `76` is not in the provided list; not used here).
`90`	(duplicate excluded)	(duplicate entry removed)
`91`	(duplicate excluded)	(duplicate entry removed)

Taxonomy Code	Specialty	Notes
`0000A`	Allergy and Immunology	Allergists commonly order and interpret allergen-specific IgG testing as part of immune evaluation.
`0000B`	Clinical Pathology / Laboratory Medicine	Laboratory medicine specialists oversee assay validation, quality control, and reporting.
`0000C`	Gastroenterology	Gastroenterologists may order IgG food panels when evaluating chronic GI symptoms related to food hypersensitivity.
`0000D`	Primary Care	Primary care physicians may order initial testing and manage follow-up recommendations.
`0000E`	Dermatology	Dermatologists may order in evaluation of chronic eczematous or contact-like dermatitis with suspected food triggers.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K58.9`	Irritable bowel syndrome without diarrhea	Frequently evaluated with food-related testing when patients report symptom-food correlations.
`R10.9`	Abdominal pain, unspecified	Non-specific abdominal pain prompting evaluation for possible food-triggered immune responses.
`L30.9`	Dermatitis, unspecified	Chronic dermatitis sometimes investigated for possible food-related triggers using IgG panels.
`R63.5`	Abnormal weight gain	Changes in weight associated with dietary modifications may prompt testing for food-related sensitivities.
`R63.4`	Abnormal weight loss	Unexplained weight loss with suspected food-related etiology can lead to comprehensive allergy testing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`80053`	Comprehensive metabolic panel	Routine baseline labs often collected at same visit to evaluate systemic causes of symptoms alongside `86001`.
`85025`	Complete blood count (CBC) with automated differential	Commonly ordered with immunologic testing to assess for eosinophilia or other hematologic findings.
`86003`	Allergen specific IgE (single allergen)	Complementary test measuring allergen-specific IgE when immediate hypersensitivity is suspected; often ordered with or instead of IgG tests.
`83036`	Hemoglobin A1c	May be ordered during metabolic evaluation of patients with chronic symptoms and comorbid metabolic disease.
`36415`	Collection of venous blood by venipuncture	Specimen collection CPT that is typically performed prior to laboratory testing including `86001`.