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    v1.0.28
    OpenPayerBilling CodesQualitative or Semiquantitative ImmunoassaysCPT cpt-86146-beta-2-glycoprotein-i-antibody-lab-test
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    CPT 86146: Beta-2 Glycoprotein I Antibody Test

    CPT code 86146 describes a laboratory technical test performed by a lab analyst to analyze a patient sample (for example, serum) for the presence of beta-2 glycoprotein I antibody, a serologic assay used in thrombophilia and autoimmune workups; service type: clinical laboratory testing; typical site of service: outpatient or hospital clinical laboratory or reference lab performing serologic antibody testing.

    For related coverage guidance, see recent payer policy updates: Diagnosis of Idiopathic Environmental Intolerance, Allergen Testing, Allergen Testing.

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    Clinical & Coding Specifications

    Clinical Context

    A 34-year-old female with a history of recurrent first-trimester pregnancy loss and a prior unexplained thrombotic event presents for a hypercoagulability evaluation. The clinician orders antiphospholipid antibody testing, including beta-2 glycoprotein I IgG and IgM. A phlebotomy technician draws a serum sample at an outpatient laboratory. The specimen is transported to the clinical laboratory where a medical laboratory scientist or lab analyst performs the 86146 assay to detect beta-2 glycoprotein I antibody in the serum. The laboratory documents one unit reported per antibody tested. Results are transmitted to the ordering clinician who integrates antibody status with clinical history to support or exclude antiphospholipid syndrome and guide peri‑pregnancy or anticoagulation management. Typical site of service: outpatient laboratory or hospital clinical laboratory. Service type: clinical immunology/serology laboratory testing (technical component). Typical patient scenario: adult patient evaluated for thrombosis or recurrent pregnancy loss where antiphospholipid antibodies are suspected.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    86147Beta-2 glycoprotein I antibody, IgM; laboratory analysisOften ordered alongside 86146 (IgG) to assess both IgG and IgM isotypes when evaluating antiphospholipid antibodies.
    86431Antibody; rheumatoid factor, single determinationMay be ordered in the broader autoimmune workup when rheumatologic disease is suspected; not specific but complementary in differential diagnosis.
    85610Prothrombin time, thromboplastin time, and INRCommon coagulation tests ordered concurrently when evaluating patients with thrombosis or anticoagulation needs.
    85301Protein C activityPart of hypercoagulability panels that can be ordered in patients with thrombotic history alongside antiphospholipid antibody testing.
    36415Collection of venous blood by venipunctureThe specimen collection CPT typically performed prior to 86146 testing in outpatient or inpatient settings.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    90Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
    91Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    57CPT® modifier -57 (“Decision for Surgery”) is appended to an Evaluation and Management (E/M) service when that encounter results in the initial decision to perform a major surgery (a procedure with a…- Use modifier 57 when an E/M service provided by the same provider (or same tax ID) on the day of or the day before a major surgical procedure (90‑day global period) results in the initial decision…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    2080P0006XDevelopmental - Behavioral Pediatrics PhysicianA developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    207LP2900XPain Medicine (Anesthesiology) PhysicianAn anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chr…
    2085R0202XDiagnostic Radiology PhysicianA radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
    2081P0010XPediatric Rehabilitation Medicine PhysicianA physiatrist who utilizes an interdisciplinary approach and addresses the prevention, diagnosis, treatment and management of congenital and childhood…
    364SL0600XLong-Term Care Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    171100000XAcupuncturistAn acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long,…

    Related Payer Policy Updates

    Specialty: Allergy/Clinical Immunology1 / 3

    10 rows

    PolicyPayerEffective Date
    Diagnosis of Idiopathic Environmental IntoleranceOscar Health2026-10-01
    Allergen Testingblue cross blue shield - louisiana2026-09-15
    Allergen TestingBlue Cross Blue Shield - New Mexico2026-09-04
    Hereditary Angioedema - EkterlyCigna2026-08-15
    Omalizumab products (Xolair, Omlyclo) coveragePremera Bluecross2026-08-01
    Omalizumab Products (Xolair, Omlyclo) coveragePremera Bluecross2026-08-01
    Omalizumab ProductsPremera Bluecross2026-08-01
    Allergy Testinguniverahealthcare2026-07-16
    Omalizumab (Xolair) and related biologics coverageMass General Brigham Health Plan2026-07-01
    Xolair (omalizumab) (Subcutaneous) — Concomitant therapy restrictions and dosing guidanceeocco2026-07-01

    Related Codes

    86803-QUALITATIVE-OR-SEMIQUANTITATIVE-IMMUNOASSAYS-HEPATITIS-C

    CPT 86803: Hepatitis C Antibody Immunoassay in Serum

    CPT-86000-FEBRILE-AGGLUTININS-SEROLOGIC-TEST

    CPT 86000: Febrile Agglutinins (Serologic Agglutination) Test

    CPT-86001-ALLERGEN-SPECIFIC-IGG-LABORATORY-TEST

    CPT 86001: Allergen-Specific IgG Assay, Technical Component

    CPT-86003-ALLERGEN-SPECIFIC-IGE-ASSAY-TECHNICAL

    CPT 86003: Allergen‑Specific IgE Assay Using Crude Allergen Extract

    CPT-86005-MULTI-ALLERGEN-IGE-SCREENING-QUALITATIVE

    CPT 86005: Multi-Allergen Allergen-Specific IgE Screening

    CPT-86008-ALLERGEN-COMPONENT-SPECIFIC-IGE-ASSAY

    CPT 86008: Allergen Component–Specific IgE Assay

    CPT-86015-ANTI-ACTIN-SMOOTH-MUSCLE-ANTIBODY-ASMA

    CPT 86015: Actin (Smooth Muscle) Antibody (ASMA) Immunoassay

    CPT-86021-LEUKOCYTE-ANTIBODY-IDENTIFICATION-LAB-TECHNICAL

    CPT 86021: Leukocyte Antibody Identification Laboratory Test

    CPT-86022-PLATELET-ANTIBODY-IDENTIFICATION-TECHNICAL-TEST

    CPT 86022: Platelet Antibody Detection and Identification

    CPT-86023-PLATELET-ASSOCIATED-IMMUNOGLOBULIN-DETECTION

    CPT 86023: Platelet-Associated Immunoglobulin Assay

    Showing 1–10 of 199

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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