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CPT 86481: T‑Cell Interferon-Gamma Release Assay for Tuberculosis Antigens

CPT code 86481 covers a laboratory immunology assay that enumerates T cells producing interferon-gamma in response to tuberculosis-related antigens. This test is used to assess cell-mediated immune response to TB antigens and plays a role in diagnosing latent or active tuberculosis infection where interferon-gamma release assays are clinically indicated. Nationally, this code matters for public health screening programs, occupational health evaluations, and laboratory reimbursement policy due to growing use of targeted TB testing.

Key payers included in the coverage analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and commonly used billing modifiers. The publication provides benchmarking and policy-relevant information on coverage trends and reimbursement considerations for laboratories and billing professionals. It also outlines clinical implications of the assay and the operational settings where the test is performed.

Data not available in the input for payer-specific rates, associated taxonomies, and ICD-10 mappings. The report focuses on national-level policy and clinical context rather than state-specific rules.

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Billing Code Overview

CPT code 86481 describes a laboratory test that evaluates an antigen-driven cellular immune response to tuberculosis-related antibodies by enumerating T cells that produce gamma interferon. The service is a specialized immunologic assay performed by a laboratory analyst to detect antigen-specific T‑cell production of interferon-gamma.

Service type: Laboratory immunology service — T‑cell interferon-gamma release assay
Typical site of service: Clinical laboratory or hospital laboratory setting

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CPT 86481: T‑Cell Interferon-Gamma Release Assay for Tuberculosis Antigens

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Billing Code Overview

Service type: Laboratory immunology service — T‑cell interferon-gamma release assay
Typical site of service: Clinical laboratory or hospital laboratory setting

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult or adolescent with suspected latent or active tuberculosis infection referred for interferon-gamma release assay (IGRA) testing. The patient presents to an outpatient clinic, occupational health clinic, public health department, or hospital lab phlebotomy station for blood draw. A clinician documents exposure history, risk factors (recent contact with infectious TB case, immunosuppression, healthcare worker screening, immigrant screening, or pre-biologic therapy evaluation), and orders IGRA testing. The specimen is collected via venipuncture, handled per manufacturer instructions (proper tube type, incubation or room temperature requirements), and transported to the laboratory. In the laboratory, a trained technologist incubates patient blood with TB-specific antigens and measures T‑cell production of interferon-gamma, typically using enzyme-linked immunosorbent assay (ELISA) or similar platforms. Results are reported as positive, negative, or indeterminate and routed back to the ordering clinician for interpretation relative to clinical history, prior Bacille Calmette-Guérin (BCG) vaccination, and risk factors.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing only the professional interpretation of the test result by a physician or qualified provider separate from the technical component.
`TC`	Technical component	When billing only the technical performance and processing of the test by the laboratory separate from professional interpretation.
`91`	Repeat clinical diagnostic laboratory test	When repeating the IGRA on the same day for the same patient to obtain a second measurement.
`59`	Distinct procedural service	When an unrelated service or specimen is billed on the same day and needs distinction from the IGRA.
`25`	Significant, separately identifiable E/M service	When an evaluation and management visit is performed and documented on the same day as specimen collection.
`90`	Reference (outside) laboratory test (when required by payor terminology)	When the specimen is forwarded to an outside reference laboratory and payors require identifying a non-local lab service.
`QW`	CLIA waived test	Rarely applicable; only if a waived IGRA platform exists and payor requires the CLIA-waived modifier (verify local payor rules).
`QK`	Physician certification statement (PCS) waived	Used for certain Medicare home health/hospice documentation; applies rarely — include only when regulatory reporting requires.
`91`	Repeat (listed above)	See prior entry — used for repeat testing for verification or indeterminate initial result.
`52`	Reduced services	When the test is partially reduced or not fully performed as described in the CPT code.
`53`	Discontinued procedure	When specimen collection or processing is started but discontinued for documented clinical reasons.
`59`	Distinct procedural service (listed above)	See prior entry for use when unrelated same‑day services require separation.
`90`	Reference lab (listed above)	See prior entry.

Taxonomy Code	Specialty	Notes
207Q00000X	Infectious Disease	Specialists who interpret TB testing results in complex cases and manage TB therapy.
207L00000X	Pulmonary Disease	Pulmonologists frequently order and interpret TB testing in patients with respiratory symptoms or exposure.
208000000X	Pathology & Laboratory Medicine	Laboratory physicians/directors oversee test validation, quality control, and result sign-out.
207K00000X	Allergy & Immunology	Immunologists may assess IGRA performance in immunocompromised patients and evaluate immune responses.
207P00000X	Preventive Medicine	Occupational and public health clinicians who order screening tests for TB for employment or public health surveillance.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z11.1`	Encounter for screening for respiratory tuberculosis	Common indication for IGRA as part of routine screening programs (occupational, pre-immigration, or community screening).
`Z20.0`	Contact with and (suspected) exposure to tuberculosis	Ordered when a patient has known exposure to an active TB case to assess latent infection.
`R50.9`	Fever, unspecified	Symptom prompting evaluation for active TB in conjunction with imaging and microbiology; IGRA may be part of the workup.
`B20`	Human immunodeficiency virus [HIV] disease	Immunocompromised patients such as those with HIV are prioritized for TB screening using IGRA.
`Z79.3`	Long term (current) use of systemic steroids	Immunosuppression from steroids increases TB activation risk; IGRA used to evaluate latent infection before immunosuppressive therapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Commonly performed immediately before IGRA testing to obtain the required blood specimen.
`85610`	Prothrombin time; one-stage	Example of a laboratory test that may be ordered concurrently; not specific to TB but often part of pre-treatment baseline labs.
`86580`	Skin test; tuberculosis, intradermal (e.g., Mantoux test), per test dose	Alternative or complementary TB screening method (PPD) performed before or instead of IGRA depending on clinical context.
`96372`	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	May be used when intradermal PPD is administered during the same visit as blood draw for IGRA.
`99000`	Handling and/or conveyance of specimen for transfer from physician's office to lab	Used when billing separately for specimen handling or courier services associated with IGRA sample transport.

86803 – Qualitative or Semiquantitative Immunoassays; Hepatitis C antibody

CPT-86000-FEBRILE-AGGLUTININS-SEROLOGIC-TEST

CPT 86000: Serologic Test for Febrile Agglutinins

CPT-86001-ALLERGEN-SPECIFIC-IGG-LABORATORY-TEST

CPT 86001: Allergen-specific Immunoglobulin G (IgG) Test

CPT-86003-ALLERGEN-SPECIFIC-IGE-ASSAY-TECHNICAL

CPT 86003: Allergen-Specific IgE Assay, Technical Component

CPT-86005-MULTI-ALLERGEN-IGE-SCREENING-QUALITATIVE

CPT 86005: Multi-Allergen IgE Screening, Qualitative

CPT-86008-ALLERGEN-COMPONENT-SPECIFIC-IGE-ASSAY

CPT 86008: Allergen Component-Specific IgE Assay

CPT-86015-ANTI-ACTIN-SMOOTH-MUSCLE-ANTIBODY-ASMA

CPT 86015: Anti‑Actin (Smooth Muscle) Antibody (ASMA) Test

CPT-86021-LEUKOCYTE-ANTIBODY-IDENTIFICATION-LAB-TECHNICAL

CPT 86021: Leukocyte Antibody Identification, Technical Laboratory Service

CPT-86022-PLATELET-ANTIBODY-IDENTIFICATION-TECHNICAL-TEST

CPT 86022: Platelet Antibody Identification, Technical Component

CPT-86023-PLATELET-ASSOCIATED-IMMUNOGLOBULIN-DETECTION

CPT 86023: Platelet-Associated Immunoglobulin Detection

Showing 1–10 of 199

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing only the professional interpretation of the test result by a physician or qualified provider separate from the technical component.
`TC`	Technical component	When billing only the technical performance and processing of the test by the laboratory separate from professional interpretation.
`91`	Repeat clinical diagnostic laboratory test	When repeating the IGRA on the same day for the same patient to obtain a second measurement.
`59`	Distinct procedural service	When an unrelated service or specimen is billed on the same day and needs distinction from the IGRA.
`25`	Significant, separately identifiable E/M service	When an evaluation and management visit is performed and documented on the same day as specimen collection.
`90`	Reference (outside) laboratory test (when required by payor terminology)	When the specimen is forwarded to an outside reference laboratory and payors require identifying a non-local lab service.
`QW`	CLIA waived test	Rarely applicable; only if a waived IGRA platform exists and payor requires the CLIA-waived modifier (verify local payor rules).
`QK`	Physician certification statement (PCS) waived	Used for certain Medicare home health/hospice documentation; applies rarely — include only when regulatory reporting requires.
`91`	Repeat (listed above)	See prior entry — used for repeat testing for verification or indeterminate initial result.
`52`	Reduced services	When the test is partially reduced or not fully performed as described in the CPT code.
`53`	Discontinued procedure	When specimen collection or processing is started but discontinued for documented clinical reasons.
`59`	Distinct procedural service (listed above)	See prior entry for use when unrelated same‑day services require separation.
`90`	Reference lab (listed above)	See prior entry.

Taxonomy Code	Specialty	Notes
207Q00000X	Infectious Disease	Specialists who interpret TB testing results in complex cases and manage TB therapy.
207L00000X	Pulmonary Disease	Pulmonologists frequently order and interpret TB testing in patients with respiratory symptoms or exposure.
208000000X	Pathology & Laboratory Medicine	Laboratory physicians/directors oversee test validation, quality control, and result sign-out.
207K00000X	Allergy & Immunology	Immunologists may assess IGRA performance in immunocompromised patients and evaluate immune responses.
207P00000X	Preventive Medicine	Occupational and public health clinicians who order screening tests for TB for employment or public health surveillance.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z11.1`	Encounter for screening for respiratory tuberculosis	Common indication for IGRA as part of routine screening programs (occupational, pre-immigration, or community screening).
`Z20.0`	Contact with and (suspected) exposure to tuberculosis	Ordered when a patient has known exposure to an active TB case to assess latent infection.
`R50.9`	Fever, unspecified	Symptom prompting evaluation for active TB in conjunction with imaging and microbiology; IGRA may be part of the workup.
`B20`	Human immunodeficiency virus [HIV] disease	Immunocompromised patients such as those with HIV are prioritized for TB screening using IGRA.
`Z79.3`	Long term (current) use of systemic steroids	Immunosuppression from steroids increases TB activation risk; IGRA used to evaluate latent infection before immunosuppressive therapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Commonly performed immediately before IGRA testing to obtain the required blood specimen.
`85610`	Prothrombin time; one-stage	Example of a laboratory test that may be ordered concurrently; not specific to TB but often part of pre-treatment baseline labs.
`86580`	Skin test; tuberculosis, intradermal (e.g., Mantoux test), per test dose	Alternative or complementary TB screening method (PPD) performed before or instead of IGRA depending on clinical context.
`96372`	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	May be used when intradermal PPD is administered during the same visit as blood draw for IGRA.
`99000`	Handling and/or conveyance of specimen for transfer from physician's office to lab	Used when billing separately for specimen handling or courier services associated with IGRA sample transport.

86803 – Qualitative or Semiquantitative Immunoassays; Hepatitis C antibody

CPT-86000-FEBRILE-AGGLUTININS-SEROLOGIC-TEST

CPT 86000: Serologic Test for Febrile Agglutinins

CPT-86001-ALLERGEN-SPECIFIC-IGG-LABORATORY-TEST

CPT 86001: Allergen-specific Immunoglobulin G (IgG) Test

CPT-86003-ALLERGEN-SPECIFIC-IGE-ASSAY-TECHNICAL

CPT 86003: Allergen-Specific IgE Assay, Technical Component

CPT-86005-MULTI-ALLERGEN-IGE-SCREENING-QUALITATIVE

CPT 86005: Multi-Allergen IgE Screening, Qualitative

CPT-86008-ALLERGEN-COMPONENT-SPECIFIC-IGE-ASSAY

CPT 86008: Allergen Component-Specific IgE Assay

CPT-86015-ANTI-ACTIN-SMOOTH-MUSCLE-ANTIBODY-ASMA

CPT 86015: Anti‑Actin (Smooth Muscle) Antibody (ASMA) Test

CPT-86021-LEUKOCYTE-ANTIBODY-IDENTIFICATION-LAB-TECHNICAL

CPT 86021: Leukocyte Antibody Identification, Technical Laboratory Service

CPT-86022-PLATELET-ANTIBODY-IDENTIFICATION-TECHNICAL-TEST

CPT 86022: Platelet Antibody Identification, Technical Component

CPT-86023-PLATELET-ASSOCIATED-IMMUNOGLOBULIN-DETECTION

CPT 86023: Platelet-Associated Immunoglobulin Detection

Showing 1–10 of 199

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 86481: T‑Cell Interferon-Gamma Release Assay for Tuberculosis Antigens

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Billing Code Overview

OpenPayer

CPT 86481: T‑Cell Interferon-Gamma Release Assay for Tuberculosis Antigens

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References