Summary & Overview
CPT 86352: Immune Function Assay by Stimulation with ATP Detection
CPT code 86352 denotes a laboratory immunologic functional assay that measures immune system suppression by stimulating cells (for example, with antigen or mitogen) and detecting biomarkers such as adenosine triphosphate (ATP). This assay is used in clinical settings to evaluate cellular immune responsiveness, important for monitoring immune status in patients with suspected immunodeficiency, post-transplant immunosuppression, or systemic conditions affecting cell-mediated immunity. Nationally, the code matters because it denotes specialized laboratory testing that can influence therapeutic decisions and utilization of immunomodulatory therapies.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the assay, guidance on typical sites of service (clinical and hospital laboratories), and an outline of what national stakeholders commonly evaluate for this service: test purpose, service setting, and payer coverage considerations. Data not available in the input for detailed payer-specific reimbursement benchmarks, associated taxonomies, and ICD-10 mappings. The publication provides concise reference material for clinicians, laboratory managers, and policy analysts seeking a clear description of CPT code 86352 and its role in laboratory assessment of immune function.
Billing Code Overview
CPT code 86352 describes an assay to evaluate immune system suppression by stimulating cell function with an agent (such as an antigen or mitogen) and detecting a biomarker like adenosine triphosphate (ATP).
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Service type: Laboratory immunologic functional assay
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Typical site of service: Clinical laboratory or hospital laboratory performing specialized immunology testing
This test assesses cellular immune responsiveness by measuring biomarker production after stimulation, supporting evaluation of immune suppression or immune function in clinical care.
Clinical & Coding Specifications
Clinical Context
A 52-year-old renal transplant recipient attends routine post-transplant surveillance due to concerns for allograft function and immunosuppressive therapy monitoring. The transplant clinic orders an immune function assay to assess cellular immune responsiveness using mitogen stimulation with biomarker detection such as adenosine triphosphate (ATP). A peripheral blood sample is collected in the clinic by a phlebotomist, labeled, and sent to the hospital reference laboratory. The lab analyst performs the assay described by 86352: lymphocyte stimulation with an agent (e.g., phytohemagglutinin) and measurement of ATP production to quantify cellular immune suppression. Results are reported to the transplant nephrologist, who reviews assay values alongside clinical findings and therapeutic drug levels. Typical workflow steps: order entry in the EHR, patient consent and phlebotomy, specimen transport to the lab, assay setup and incubation, biomarker measurement and quality control, result validation, and electronic reporting to the ordering provider.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the physician or lab professional interpretation of the test separate from the technical component |