Summary & Overview

CPT 86362: MOG–IgG1 Antibody Test by Cell-Based Assay

Headline: CPT code 86362 identifies MOG–IgG1 antibody testing by cell-based assay.

Lead: CPT code 86362 denotes a laboratory assay for myelin oligodendrocyte glycoprotein immunoglobulin G1 (MOG–IgG1) using a cell–based immunofluorescence method on serum. The test is clinically important for distinguishing neuromyelitis optica spectrum disorders from MOG–associated encephalomyelitis and can influence diagnostic and care pathways for inflammatory demyelinating diseases.

Why it matters nationally: As awareness of MOG–IgG1–related disorders grows, demand for specific, validated serologic testing has increased across neurology and neuroimmunology practices. Accurate coding enables appropriate laboratory billing, utilization tracking, and policy development for specialty testing.

Key payers covered: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

What readers will learn: This publication provides clinical context for CPT code 86362, explains the test method and typical site of service, and summarizes payer coverage scope. Readers will find benchmarks for how the code is used in practice, summaries of relevant policy considerations affecting coverage and prior authorization, and guidance on documentation elements relevant to claims adjudication. The report focuses on national implications for laboratory and neurology stakeholders.

Scope note: Associated taxonomies, ICD-10 mappings, related codes, and payer-specific policy details are addressed in dedicated sections. Data not available in the input are noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare86362CPTMyelin Oligodendrocyte GlycoproteinMOG-IgG1Cell-based AssaySerologyNeurologyLaboratory Testing

Billing Code Overview

CPT code 86362 describes a laboratory test to detect antibody to myelin oligodendrocyte glycoprotein (MOG–IgG1), most commonly performed on a serum specimen. The assay method for this test is a cell–based immunofluorescence assay (CBA).

Service type: Specialty serologic laboratory test

Typical site of service: Clinical laboratory or reference laboratory

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 28-year-old woman presents to neurology with acute optic neuritis and transverse myelitis symptoms. Initial workup includes MRI of the brain and spinal cord and serologic testing for antibodies associated with demyelinating disorders. After a negative AQP4 (aquaporin-4) antibody test, the clinician orders testing for myelin oligodendrocyte glycoprotein antibody using a cell-based immunofluorescence assay billed with 86362 on a serum specimen to evaluate for MOG–IgG1–associated disease (MOG–encephalomyelitis). The typical workflow: outpatient neurology encounter → blood draw phlebotomy labeled for MOG–IgG1 (CBA) → specimen sent to reference laboratory → lab performs cell-based immunofluorescence assay and reports qualitative/quantitative results → results reviewed by ordering neurologist to distinguish neuromyelitis optica spectrum disorder from MOG–EM and guide further management and counseling. Typical site of service is an outpatient clinic or specialized neurology infusion/diagnostic center with samples processed in a clinical immunology or reference laboratory.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the professional interpretation component if separated from the technical lab component.
`TC`	Technical component	Use when billing only the laboratory/technical component (processing and testing) without the professional interpretation.
`90`	Reference laboratory	Use when the service is performed by a separate laboratory from the billing provider (reference lab billing).
`52`	Reduced services	Use when the assay is partially performed or a modified/limited test is done with reduced scope.
`53`	Discontinued procedure	Use if specimen collection or testing was started but discontinued for documented clinical reasons.
`59`	Distinct procedural service	Use when this test is distinct from other services performed the same day and documentation supports medical necessity for separate billing.
`90`	(duplicate intentionally omitted — already listed)
`90`	(see above)
`90`	(see above)
`QW`	CLIA-waived test	Not applicable for `86362` (CBA is not CLIA-waived); do not use except when explicitly appropriate.
`QX`	Clinical lab test performed by a CAP/CLIA certified laboratory under a physician's supervision	Use when applicable to designate the performer under applicable regulatory program (where payer requires such modifier for lab performers).
`QY`	Laboratory test performed by an independent laboratory meeting payer-specified requirements	Use when payer requires indicating independent lab performed the test.
`90`	(repetition removed)

Taxonomy Code	Specialty	Notes
`207RH0000X`	Neurology	Ordering specialty commonly managing demyelinating disorders.
`2084N0400X`	Pathology and Clinical Pathology	Laboratory specialty overseeing immunology assays and result interpretation.
`363A00000X`	Phlebotomy Technician	Performs blood specimen collection for serologic testing.
`207K00000X`	Neurology – Pediatric	Pediatric neurologists order this test for children with suspected MOG disease.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G36.0`	Neuromyelitis optica	Distinguishing AQP4-positive NMO from MOG–IgG1–associated disease influences diagnosis and treatment.
`G37.1`	Other demyelinating disease of central nervous system	Used when demyelinating disease is suspected but specific classification is pending.
`G04.81`	Neuromyelitis optica spectrum disorder	Clinical indication to test for MOG–IgG1 after AQP4 results to clarify etiology.
`H46.9`	Optic neuritis, unspecified	Common presenting symptom prompting MOG–IgG1 testing in the differential for optic neuritis.
`G04.89`	Other inflammatory diseases of central nervous system	Used when inflammatory CNS disease is suspected and serologic testing for MOG is ordered.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Performed to obtain the serum specimen sent for `86362` testing.
`88360`	Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain	Sometimes used in specialty labs for confirmatory immunostaining techniques complementary to cell-based assays.
`86141`	Antibody; infectious agent (e.g., antibody titer), qualitative or semi-quantitative	Represents other serologic antibody tests that may be ordered alongside `86362` in differential workup.
`86336`	Antibody; quantitative or semi-quantitative (e.g., ANA or autoantibody panels)	Commonly ordered as part of broader autoimmune evaluations when considering demyelinating disease.
`82623`	Immunoassay for tumor marker or similar analyte	Represents analogous immunoassay methodology components in the lab workflow for specialized tests.