Summary & Overview
CPT 86060: Antistreptolysin O (ASO) Titer, Serology
CPT code 86060 represents the antistreptolysin O (ASO) titer, a serologic laboratory test reporting antibody titers to streptolysin O. This test is used clinically to evaluate exposure to group A Streptococcus and can support diagnosis or monitoring of conditions associated with prior streptococcal infection. Nationally, ASO testing is a routine laboratory service with implications for outpatient and inpatient diagnostic workflows and laboratory reimbursement policies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for ordering an ASO titer, typical sites of service, and common billing considerations tied to CPT code 86060. The publication provides benchmarks where available, notes on payer coverage scope, and relevant policy updates affecting laboratory reimbursement and claim processing for serologic testing.
The report aims to help billing staff, laboratory managers, and policy analysts understand how CPT code 86060 is classified, where it is performed, and the administrative context for claims. Data not available in the input is identified explicitly in the sections where it applies.
Billing Code Overview
CPT code 86060 describes a laboratory antistreptolysin O (ASO) titer test performed by a lab analyst to detect antibodies to streptolysin O in a blood sample. The result is reported as a titer, typically used to assess recent or past infection with group A Streptococcus.
Service type: Clinical laboratory testing (serology)
Typical site of service: Clinical laboratory or hospital laboratory—blood specimen collection and laboratory processing
Clinical & Coding Specifications
Clinical Context
A typical patient is a school-age child or adult presenting to outpatient primary care or an urgent care clinic with a recent history of sore throat, fever, and tender anterior cervical lymphadenopathy. The clinician performs a throat exam and, if streptococcal infection is suspected or for epidemiologic evaluation, orders a serum antistreptolysin O (ASO) titer. A phlebotomy technician collects a blood sample; the clinical laboratory performs the 86060 assay to measure antistreptolysin O antibodies and reports a quantitative titer. Results are reviewed by the ordering clinician to help evaluate recent Group A Streptococcus exposure or to support the diagnosis of post-streptococcal sequelae such as acute rheumatic fever or post-streptococcal glomerulonephritis.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation component if split billing applies and the lab charges technical component separately. |
TC | Technical component | Use when billing only the laboratory technical component (most common for ). |