Summary & Overview
CPT 86328: SARS-CoV-2 Antibody Immunoassay
CPT code 86328 represents a single-step immunoassay used to qualitatively or semiquantitatively evaluate a patient specimen for antibodies to SARS–CoV–2, the virus responsible for COVID–19. This laboratory serology test is nationally relevant for post-infection surveillance, public health reporting, and some clinical decisions regarding prior exposure. Payers commonly covering or adjudicating claims for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of the clinical purpose of the test, the typical laboratory settings where it is performed, and the payer landscape. The publication summarizes common modifiers and billing considerations, outlines where the code fits within laboratory service lines, and highlights clinical context for interpreting qualitative and semiquantitative antibody results. It also identifies gaps where input data was not provided.
This analysis is written for a national audience and focuses on benchmarks, billing practice context, and policy-relevant implications of antibody immunoassay testing using CPT code 86328 without making clinical recommendations.
Billing Code Overview
CPT code 86328 describes a single-step immunoassay performed by a laboratory analyst to qualitatively or semiquantitatively detect antibodies to SARS–CoV–2, the virus that causes COVID–19. The test result indicates presence or approximate level of specific antibodies in a patient specimen.
Service Type: Laboratory serology testing (antibody immunoassay)
Typical Site of Service: Clinical laboratories, hospital laboratories, and other certified diagnostic lab facilities
Clinical & Coding Specifications
Clinical Context
A 42-year-old outpatient presents to an ambulatory laboratory after recent exposure to a household contact with confirmed COVID-19 and reports mild upper respiratory symptoms that began three days ago. The clinician orders a SARS–CoV–2 antibody screen to assess prior exposure and possible serologic response following a recent resolved illness or vaccination. A phlebotomy technician collects a venous blood specimen; the specimen is sent to the clinical laboratory. A medical technologist performs a single-step immunoassay to qualitatively or semiquantitatively detect antibodies to SARS–CoV–2 using an automated platform. Results are verified by the laboratory analyst, documented in the electronic health record, and the ordering clinician is notified of a reactive or nonreactive result for clinical interpretation and follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component by the laboratory physician when required separate from the technical processing. |
TC | Technical component | Use when billing only the technical component (laboratory equipment, supplies, and technician time) without the professional interpretation. |