Summary & Overview

CPT 86325: Immunoelectrophoresis of Concentrated Body Fluids

CPT code 86325 represents immunoelectrophoresis (IEP) performed on concentrated body fluids other than serum — such as urine or cerebrospinal fluid — to identify and quantify immunoglobulins. This specialized laboratory procedure supports diagnosis and monitoring of immune disorders, monoclonal gammopathies, and certain neurologic or renal conditions where evaluation of antibodies in non-serum fluids is clinically relevant. Nationally, accurate coding and consistent coverage policies for immunologic laboratory assays affect lab reimbursement, access to diagnostic testing, and clinical workflows for hospitals and outpatient labs.

Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical purpose and typical service settings for CPT code 86325, plus what to expect from payer coverage perspectives. The publication summarizes benchmarking considerations, relevant billing modifiers and common payer requirements, and the clinical context that informs test utilization. This report is intended to help billing managers, lab directors, and policy analysts understand the role of CPT code 86325 in diagnostic workflows and payer interactions at a national level.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 86325immunoelectrophoresislaboratory testingimmunologybody fluid analysisclinical laboratoryimmunoglobulin testingdiagnostic coding

Billing Code Overview

CPT code 86325 describes immunoelectrophoresis (IEP) performed on a patient body fluid other than serum — for example, urine or cerebrospinal fluid — with concentration, to evaluate the amounts and types of immunoglobulins (antibodies) present. The test identifies and characterizes protein patterns produced by the immune system, aiding in the detection of abnormal or monoclonal immunoglobulin production.

Service Type: Laboratory — immunology serology testing (concentrated body fluid immunoelectrophoresis)

Typical Site of Service: Clinical laboratory or hospital laboratory, including outpatient lab settings or inpatient hospital lab processing

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with a history of unexplained neurologic symptoms and episodic headaches presents with concern for possible central nervous system inflammation or monoclonal gammopathy. The treating neurologist collects cerebrospinal fluid (CSF) via lumbar puncture and sends a concentrated CSF specimen to the clinical laboratory for immunoelectrophoresis to evaluate immunoglobulin types and patterns. The laboratory analyst performs 86325 (immunoelectrophoresis of body fluid other than serum, with concentration) to detect oligoclonal bands or abnormal immunoglobulin production. Results are used by the neurologist and consulting specialists to support diagnoses such as multiple sclerosis, CNS infection, or leptomeningeal malignancy and to guide further testing (e.g., serum/CSF paired studies) and management decisions. Typical site of service is an outpatient hospital laboratory or independent clinical laboratory; specimen collection occurs in an ambulatory clinic, emergency department, or inpatient setting prior to laboratory testing. The workflow includes specimen collection and labeling, concentration of the non-serum body fluid (for example, CSF or urine), performance of immunoelectrophoresis by a trained lab technologist, interpretation and reporting by laboratory staff, and transmission of results to the ordering clinician.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the professional component if separate technical component is billed by another entity.
`TC`	Technical component	Use when reporting only the technical component of the laboratory procedure.
`90`	Reference (outside) laboratory	Use when the performing laboratory refers the specimen to an outside reference laboratory for `86325`.
`91`	Repeat clinical diagnostic laboratory test	Data not available in the input.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally intended.
`53`	Discontinued procedure	Use when the procedure was started but discontinued due to unforeseen circumstances.
`59`	Distinct procedural service	Data not available in the input.
`76`	Repeat procedure by same provider	Data not available in the input.
`77`	Repeat procedure by another provider	Data not available in the input.
`90`	Duplicate entry removed above to avoid repetition	Data not available in the input.

Taxonomy Code	Specialty	Notes
`LAB-000`	Clinical Laboratory Scientist / Medical Technologist	Performs specimen processing and immunoelectrophoresis in the lab.
`207L00000X`	Pathology	Pathologists interpret complex electrophoresis results and provide consultative reports.
`208000000X`	Neurology	Orders CSF immunoelectrophoresis when evaluating suspected CNS inflammatory or demyelinating disease.
`207K00000X`	Hematology	Orders and interprets electrophoretic studies when assessing monoclonal gammopathies.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G35`	Multiple sclerosis	CSF immunoelectrophoresis can detect oligoclonal bands supportive of MS diagnosis.
`G04.89`	Other encephalitis, myelitis and encephalomyelitis	CSF protein electrophoresis aids in evaluation of inflammatory CNS processes.
`C79.31`	Secondary malignant neoplasm of brain	Evaluation for malignant monoclonal proteins or leptomeningeal disease can include CSF electrophoresis.
`R56.9`	Unspecified convulsions	When seizures prompt CSF analysis to assess for CNS infection or inflammation.
`N39.0`	Urinary tract infection, site not specified	Urine immunoelectrophoresis may be used in atypical workups when protein abnormalities are suspected.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Often performed prior to or concurrent with body fluid collection to obtain serum for paired comparisons with `86325`.
`62270`	Spinal puncture, lumbar; diagnostic	Procedure used to obtain cerebrospinal fluid specimen that may be sent for `86325`.
`84157`	Albumin; urine (qualitative or quantitative)	Urine/CSF protein testing that may be ordered alongside immunoelectrophoresis for protein quantitation.
`83970`	Protein; total, direct measurement	May be performed on the same specimen to quantify total protein before electrophoretic separation.