Summary & Overview
CPT 86335: Immunofixation Electrophoresis on Non-Serum Fluids
CPT code 86335 represents immunofixation electrophoresis performed on fluids other than serum (for example, urine or cerebrospinal fluid) to detect and characterize monoclonal immunoglobulins. This laboratory procedure is clinically important for diagnosing and monitoring monoclonal gammopathies such as multiple myeloma, and it affects reimbursement and utilization across inpatient and outpatient laboratory settings nationwide.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise overview of clinical uses, typical sites of service, and payer coverage considerations. Readers will find benchmarking context, service-line placement for lab billing, and a summary of common modifiers associated with laboratory procedures when available. The document also outlines the clinical rationale for testing and operational considerations for labs and hospital laboratories performing the service.
This summary is intended for coding managers, lab directors, and revenue-cycle professionals seeking a national perspective on CPT code 86335, its clinical role in evaluating monoclonal gammopathies, and high-level payer coverage context. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 86335 describes immunofixation electrophoresis performed on body fluids other than serum, such as urine or cerebrospinal fluid. The test is used to detect and characterize monoclonal immunoglobulins and supports diagnosis or monitoring of monoclonal gammopathies, including multiple myeloma.
Service Type: Laboratory — immunodiagnostic procedure
Typical Site of Service: Clinical laboratory or hospital laboratory
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a history of monoclonal gammopathy of undetermined significance (MGUS) and progressive back pain is referred for laboratory evaluation to assess for multiple myeloma. The clinician collects a 24-hour urine sample and, when indicated, cerebrospinal fluid (CSF) obtained during diagnostic lumbar puncture. The clinical laboratory performs immunofixation electrophoresis to detect and characterize monoclonal immunoglobulins (M-proteins) in fluids other than serum, most commonly urine (Bence Jones proteins) or CSF. Results guide diagnosis, staging, and monitoring of plasma cell dyscrasias — for example, confirming a urine monoclonal light chain band in suspected myeloma, or detecting oligoclonal bands in CSF when evaluating central nervous system involvement. Typical workflow: specimen receipt and accessioning, concentration of urine if required, electrophoresis run, immunofixation with appropriate antisera, documentation of patterns, technologist review, pathologist sign-out, and reporting to the ordering provider. Usual site of service is the clinical laboratory within a hospital, independent reference laboratory, or outpatient infusion/oncology clinic when laboratory services are onsite.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component performed by a pathologist for the immunofixation study. |