Summary & Overview
CPT 86023: Platelet-Associated Immunoglobulin Detection
CPT code 86023 represents a laboratory immunology test that detects and identifies platelet-associated immunoglobulins. Nationally, this test is used in the evaluation of suspected immune-mediated thrombocytopenia and other platelet disorders where antibody binding to platelets is clinically relevant. The code captures the technical laboratory work performed to analyze patient blood specimens for platelet-bound immunoglobulins.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the assay, typical sites of service, and the types of benchmarks and policy topics commonly associated with specialized laboratory testing. The publication summarizes standard utilization considerations, coding context, and payer coverage themes relevant to CPT code 86023.
This summary does not include state-specific policy details. Data not available in the input will be identified as such in the relevant sections.
Billing Code Overview
CPT code 86023 describes a laboratory test in which a lab analyst performs the technical procedures to detect and identify platelet-associated immunoglobulins in a patient’s blood. This assay evaluates whether immunoglobulins are bound to platelets, a finding that can inform the diagnosis of immune-mediated platelet disorders.
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Service type: Clinical laboratory immunology test (technical component)
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Typical site of service: Clinical laboratory or hospital laboratory performing specialized hematology/immunology testing
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Clinical & Coding Specifications
Clinical Context
A 48-year-old patient presents to the hematology clinic with unexplained thrombocytopenia and mucocutaneous bleeding. The clinician orders laboratory evaluation to determine whether platelet-associated immunoglobulins are present to support a diagnosis of immune thrombocytopenic purpura (ITP) or other immune-mediated platelet destruction. A phlebotomy draw is performed in the outpatient lab; the specimen is labeled and transported to the hospital clinical immunology laboratory. The lab analyst performs 86023, a technical assay that detects and identifies platelet-associated immunoglobulins. Results are reported to the ordering hematologist, who integrates these findings with CBC, peripheral smear, and clinical history to confirm immune-mediated platelet loss or to pursue alternate etiologies such as drug-induced thrombocytopenia or post-transfusion purpura. Typical site of service is an outpatient clinical laboratory or hospital clinical laboratory within an ambulatory or inpatient setting. The service type is a clinical laboratory diagnostic immunology test performed by a certified medical technologist or lab analyst.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component if applicable (rare for purely technical immunoassays). |