Summary & Overview
CPT 86152: Immunologic Cell Quantification, Circulating Tumor Cells
Headline: CPT code 86152: Laboratory Immunologic Cell Quantification for Circulating Tumor Cells
Lead: CPT code 86152 represents an immunologic laboratory assay to quantify specific cell populations in body fluids — most commonly used to detect and measure circulating tumor cells in blood. This test supports oncology care, disease monitoring, and treatment response assessment and has growing clinical relevance as precision medicine expands.
CPT code 86152 is a laboratory procedure code for immunologic quantification of cells using specific markers. It matters nationally because such assays increasingly inform cancer staging, therapy selection, and monitoring, influencing clinical decision-making and utilization of high-cost therapies. Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of the code’s clinical context, typical sites of service, and payer coverage scope. The publication outlines benchmarks and reimbursement context where available, summarizes relevant policy and billing considerations affecting laboratory services, and highlights clinical applications such as oncology monitoring. Data not provided in the input (for example, associated taxonomies, specific ICD-10 pairings, and detailed payer policy nuances) are noted as unavailable and will be addressed where supplemental payer policy documents exist.
Billing Code Overview
CPT code 86152 describes a laboratory immunologic test performed by a lab analyst to evaluate the quantity of specific cells in a body fluid, such as measuring circulating tumor cells in blood using immunologic markers. The procedure involves identifying and quantifying target cell populations with antibody-based or similar immunologic techniques.
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Service type: Laboratory immunologic cell quantification
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Typical site of service: Clinical laboratory or hospital laboratory, with specimens commonly collected in outpatient clinics or inpatient settings prior to laboratory analysis
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a known or suspected hematologic malignancy or metastatic solid tumor who requires monitoring for tumor cells circulating in peripheral blood or other body fluids. The oncology clinic orders an immunophenotyping quantitative assay when there is clinical concern for disease progression, relapse, minimal residual disease after chemotherapy or bone marrow transplant, or when atypical circulating cells are detected on a peripheral smear. A phlebotomy technician collects a peripheral blood sample (or other body fluid such as cerebrospinal fluid or pleural effusion) and forwards it to the clinical laboratory. In the lab, a medical technologist or lab analyst prepares specimens, performs immunologic marker staining (for example, flow cytometry with antibody panels), and enumerates specific cell populations to report the quantity of tumor or abnormal cells. Results are reviewed by a pathologist or laboratory director and transmitted to the ordering oncologist for treatment decisions or further diagnostics. Typical sites of service include hospital-based outpatient laboratories, hospital inpatient laboratories, and independent reference laboratories supporting oncology clinics and infusion centers.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the professional (interpretation) portion of the test performed by a pathologist or laboratory physician. |