Summary & Overview

CPT 86148: Antiphosphatidylserine Antibody Test, Technical Component

CPT code 86148 designates the technical component of an antiphosphatidylserine antibody (APA) laboratory test used to detect phospholipid-directed antibodies associated with clotting disorders, autoimmune disease, and pregnancy complications. Nationally, this code matters because accurate laboratory identification of these antibodies informs diagnostic pathways for thrombotic risk and autoimmune evaluation, influencing downstream clinical management and utilization of specialty services.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines how coverage and billing practices for laboratory immunoassays intersect with payer policies and lab operations.

Readers will learn the clinical context for ordering the APA test, typical sites of service (clinical and hospital laboratories), and the scope of services represented by the code. The report provides benchmarks for use, summarizes relevant policy and coverage considerations at a national level, and explains implications for billing workflows and documentation. Data not available in the input will be explicitly noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare86148CPTantiphosphatidylserinephospholipid-antibodylaboratory-diagnosticsimmunoassayhematologypregnancy-complicationsautoimmune-disease

Billing Code Overview

CPT code 86148 describes a laboratory technical procedure for an antiphosphatidylserine antibody (APA) test. The service involves the lab analyst performing the technical laboratory steps to detect antibodies directed against phosphatidylserine-associated proteins on cell membranes and platelets. These phospholipid antibodies are clinically relevant in patients with clotting disorders, autoimmune disease, and pregnancy complications.

Service type: Laboratory diagnostics — immunoassay/serologic testing

Typical site of service: Clinical laboratory or hospital laboratory (inpatient or outpatient)

Clinical & Coding Specifications

Clinical Context

A 34-year-old woman with recurrent first-trimester pregnancy loss and a history of unprovoked venous thromboembolism is referred by her obstetrician for laboratory evaluation for antiphospholipid antibodies. A phlebotomy order is placed for an antiphosphatidylserine antibody (APA) panel. A laboratory phlebotomist collects a serum sample during an outpatient visit at an ambulatory laboratory or hospital outpatient phlebotomy clinic. The specimen is transported to the clinical immunology laboratory where a medical laboratory scientist performs the technical assay steps (sample preparation, incubation with antigen, washing, detection reagent application, and reading) to detect antiphosphatidylserine antibodies. Results are reviewed by a pathologist or clinical immunologist who issues the interpretive report.

Typical site of service: outpatient ambulatory laboratory, hospital outpatient laboratory, or reference clinical immunology laboratory.

Typical patient workflow: provider orders the APA test as part of thrombophilia or antiphospholipid syndrome evaluation; patient arrives for blood draw; specimen labeled and sent to the lab; technical performance of the assay using enzyme immunoassay or other validated method; technical data captured and sent to reporting provider with interpretive comment if applicable.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When reporting the physician or pathologist interpretation separate from the technical lab work if applicable.
`TC`	Technical component	When the billing entity is reporting only the laboratory technical component of the test.
`90`	Reference (outside) laboratory	When the specimen is sent to an outside reference laboratory for processing.
`91`	Repeat clinical diagnostic laboratory test	When the test is repeated on the same day for verification of technical reproducibility.
`59`	Distinct procedural service	When a separate, unrelated laboratory service is performed the same day and needs to be distinguished.
`76`	Repeat procedure by same provider	When the laboratory repeats the assay one or more times for the same patient by the same lab (note: use only if clinically required).
`77`	Repeat procedure by another provider	When the test is repeated by a different laboratory or lab provider.
`90`	Reference (outside) laboratory	When the lab performs billing for the sending facility but test is completed at a reference lab.
`52`	Reduced services	When the lab performed a modified or partial test procedure (technical reduction).
`53`	Discontinued procedure	When the assay was started but discontinued for clinical or specimen issues.
`59`	Distinct procedural service	When distinct laboratory procedures on the same day require separation for correct payment.
`QX`	Ordering/servicing clinician relationship	When the performing laboratory documents that the ordering clinician provided necessary supervision or components per payer requirements (used with CLIA-related billing situations).
`QY`	Ordering/servicing lab relationship	When the performing laboratory is CLIA-certified and the test was ordered by a qualified provider under an approved arrangement.

Taxonomy Code	Specialty	Notes
335P00000X	Pathology	Pathologists provide interpretation of immunology/coagulation serology results.
207RC0000X	Clinical Laboratory	Medical Laboratory Scientists and lab departments performing the technical assay.
207L00000X	Clinical Immunology	Specialists in laboratory immunology overseeing antibody testing methods and validation.
208D00000X	Obstetrics & Gynecology	OB/GYNs commonly order antiphospholipid antibody testing for recurrent pregnancy loss.
207LP2900X	Hematology	Hematologists order and interpret thrombophilia and antiphospholipid testing in clotting disorder evaluation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D68.9`	Coagulation defect, unspecified	Used when evaluating patients with unexplained clotting abnormalities where antiphosphatidylserine antibodies may be contributory.
`D68.51`	Antiphospholipid syndrome	Primary diagnosis directly indicating testing for antiphospholipid antibodies including antiphosphatidylserine.
`O26.89`	Other specified pregnancy related conditions	Used when pregnancy complications prompt testing for antiphospholipid antibodies.
`O03.9`	Spontaneous abortion, complete or unspecified	Ordered in recurrent pregnancy loss evaluation to assess for autoimmune causes.
`I82.401`	Acute embolism and thrombosis of unspecified deep veins of right lower extremity	Clinical presentation prompting thrombophilia workup including antiphospholipid antibody testing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`86336`	Immunoassay for infectious disease antibody, quantitative, each	Performed in the same immunoassay laboratory setting when multiplex serology panels are run; similar technical workflow.
`86850`	Antinuclear antibody (ANA) test	Often ordered alongside antiphospholipid testing in autoimmune disease workups; performed by immunology lab.
`85379`	Lupus anticoagulant testing, panel	Directly related to antiphospholipid syndrome evaluation; typically ordered in the same diagnostic algorithm.
`86255`	Anticardiolipin antibodies, by binding assay	Another antiphospholipid antibody test commonly ordered with antiphosphatidylserine antibody to assess antiphospholipid syndrome.
`86038`	Rheumatoid factor; quantitative	May be ordered in broader autoimmune serologic evaluations and shares laboratory platforms or procedures.