Summary & Overview
CPT 86141: High-Sensitivity C-Reactive Protein (hsCRP) Laboratory Test
CPT code 86141 represents the technical laboratory component for high-sensitivity C-reactive protein (hsCRP) testing, a widely used assay to assess systemic inflammation and stratify cardiovascular risk. Nationally, hsCRP testing is frequently ordered as part of preventive cardiology, risk assessment, and inflammatory disease evaluation, making accurate coding and billing for the technical component important for lab operations and payer adjudication. Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of what CPT code 86141 covers, typical sites of service, and how this test fits into clinical workflows. The publication outlines common billing practices, relevant modifiers provided in the input, and operational benchmarks where available. It also summarizes clinical context for hsCRP testing and highlights considerations that affect lab reporting and payer processing. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 86141 describes a laboratory technical procedure in which a lab analyst performs testing to measure high-sensitivity C-reactive protein (hsCRP) in a patient specimen, frequently serum. The service type is clinical laboratory testing — high-sensitivity CRP assay. The typical site of service is a clinical laboratory or hospital laboratory where trained laboratory personnel process and analyze blood specimens for cardiovascular risk assessment and inflammatory marker evaluation.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting for cardiovascular risk assessment or monitoring of systemic inflammation. A primary care physician orders a high-sensitivity C-reactive protein (hsCRP) test when evaluating risk for atherosclerotic cardiovascular disease or assessing low-grade chronic inflammation in patients with metabolic syndrome, family history of coronary artery disease, or unexplained persistent fatigue. The clinical workflow: the patient checks in at an outpatient clinic or lab draw site (ambulatory phlebotomy or hospital outpatient laboratory), a phlebotomist collects a serum specimen via venipuncture, the specimen is labeled and transported to the clinical laboratory, the lab analyst performs the technical assay for 86141 (hsCRP) and documents results in the laboratory information system, the signing provider reviews results and incorporates them into risk stratification or management plans. Typical site of service: outpatient laboratory, hospital outpatient lab, or ambulatory clinic with phlebotomy services.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing the physician interpretation or consultation portion separate from the lab's technical component, though 86141 is a technical lab test and 26 is rarely appended to it. |
TC | Technical component | Use when the laboratory reports only the technical component of the test (common for 86141). |
90 | Reference (outside) laboratory | Use when the performing lab sends the specimen to an outside reference laboratory for analysis. |
91 | Repeat clinical diagnostic laboratory test | Use when a test is repeated on the same day on the same patient for verification of results. |
59 | Distinct procedural service | Use when a separate, distinct lab service is performed that is not usually billed together with another procedure on the same day. |
QW | CLIA waived test | Use when a CLIA-waived version of the hsCRP test is performed (if applicable under payer policy). |
90 | Outside lab (duplicate entry avoided) | See above — note: 90 is commonly used; duplicate listing omitted. |
91 | Repeat test (duplicate entry avoided) | See above. |
90 | (Duplicate entries not permitted) | Avoid duplicate modifiers in billing lines. |
59 | (See above) | Distinct service indicator; included for clarity. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207Q00000X | Clinical Pathology | Laboratory physicians and pathologists overseeing clinical chemistry testing. |
| 207L00000X | Clinical Laboratory | Medical laboratory technologists and scientists performing the assay. |
| 363A00000X | Phlebotomy | Phlebotomists who collect the specimen prior to testing. |
| 207K00000X | Hematology & Hemotherapy | Specialists who may order or supervise inflammatory marker testing for hematologic conditions. |
| 207RC0000X | General Practice | Primary care physicians ordering hsCRP for cardiovascular risk assessment. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I25.10 | Atherosclerotic heart disease of native coronary artery without angina pectoris | hsCRP used in cardiovascular risk stratification for patients with coronary artery disease. |
E78.5 | Hyperlipidemia, unspecified | hsCRP may be measured as part of cardiovascular risk assessment in patients with dyslipidemia. |
E66.9 | Obesity, unspecified | Obesity is associated with chronic low-grade inflammation; hsCRP can quantify inflammatory burden. |
M79.7 | Fibromyalgia | hsCRP may be used to exclude inflammatory etiologies when patients present with diffuse pain. |
R53.83 | Other fatigue | hsCRP can be ordered when evaluating nonspecific symptoms where inflammation is a potential contributor. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
36415 | Collection of venous blood by venipuncture | Specimen collection procedure typically performed immediately before 86141. |
80053 | Comprehensive metabolic panel (CMP) | Commonly ordered alongside hsCRP for cardiovascular risk and metabolic assessment. |
85025 | Complete blood count (CBC) with automated differential | May be ordered with hsCRP when evaluating systemic inflammation or infection. |
84484 | Troponin I | Cardiac biomarker that can be ordered with hsCRP in acute or chronic cardiac risk evaluations. |
86480 | Rheumatoid factor | Autoimmune panel tests that may be ordered in parallel when inflammatory disorders are suspected. |