Summary & Overview
CPT 86376: Microsomal Autoantibody Immunoassay, Serum
CPT code 86376 represents a laboratory immunoassay for microsomal autoantibodies, commonly performed on serum to detect antibodies such as liver-kidney microsomal (LKM1) and thyroid peroxidase (TPO). These assays help identify autoimmune hepatitis and autoimmune thyroid disorders, making the code important for diagnostic workflows in clinical immunology and endocrinology. Nationally, this test is routinely ordered by specialists and primary care clinicians when autoimmune liver or thyroid disease is suspected.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise overview of billing and clinical context for CPT code 86376, along with typical sites of service and common administrative considerations.
Readers will learn the clinical purpose of the test, the typical laboratory service setting, and which major payers are relevant for coverage and claims processing. Where detailed benchmarking or payer-specific policy language is required, this summary notes whether that information is available. Data not available in the input will be indicated as such in the corresponding sections of the full publication.
Billing Code Overview
CPT code 86376 describes an immunoassay performed by a laboratory analyst to detect microsomal autoantibodies in a biological specimen, typically serum. These antibodies include liver-kidney microsomal antibodies (such as LKM1) and thyroid peroxidase antibodies (such as TPO), which are associated with autoimmune hepatitis and autoimmune thyroid disease, respectively.
Service type: Laboratory immunoassay / serology testing
Typical site of service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A 42-year-old female presents to a hepatology clinic with fatigue, elevated liver enzymes on routine labs, and a history of autoimmune thyroid disease. The ordering physician requests serologic testing for microsomal autoantibodies (such as liver-kidney microsomal antibodies LKM1 and thyroid peroxidase/TPO antibodies) to evaluate for autoimmune hepatitis and autoimmune thyroiditis. A phlebotomist collects a serum sample in an outpatient laboratory or hospital outpatient draw station. The laboratory accessioning technician logs the specimen and routes it to the immunology/serology lab. A medical laboratory scientist performs the technical assay for microsomal antibodies, documents results in the laboratory information system, and the pathologist or lab director reviews and signs out the result. Results are transmitted to the ordering provider for correlation with clinical findings and further management decisions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing the physician interpretation/review separate from the lab technical component (rare for most lab tests). |
TC | Technical component | Use when billing only the laboratory technical component of the test. |