Summary & Overview
CPT 86590: Streptokinase Antibody Serologic Test
CPT code 86590 represents a serologic laboratory assay for detection of streptokinase antibody in patient blood. This diagnostic test has clinical relevance when assessing immune response to prior streptokinase exposure or evaluating suspected antibody-mediated interference with streptokinase-based therapies. Nationally, accurate coding and reporting of this test support clinical decision-making, laboratory quality metrics, and appropriate reimbursement.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns, coding and billing considerations, and typical sites of service for laboratories offering this assay.
Readers will find concise benchmarks and practical context: an explanation of the clinical indication and laboratory service type, how payers commonly classify and reimburse the assay, and operational notes relevant to lab billing lines. The report also highlights policy updates and payer guidance where available, and clarifies data availability when specific payer policies are not provided. This national overview is intended for laboratory managers, billing professionals, and clinicians who need a clear, code-focused resource on CPT code 86590.
Billing Code Overview
CPT code 86590 describes a laboratory test performed by a lab analyst to evaluate the presence of streptokinase antibody in a patient’s blood. This service is a diagnostic serologic assay that detects antibodies generated in response to streptokinase exposure.
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Service type: Serologic laboratory test
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Typical site of service: Clinical laboratory or hospital laboratory setting
Clinical & Coding Specifications
Clinical Context
A 48-year-old patient with a history of streptococcal infection and prior thrombolytic therapy presents for serologic assessment of prior exposure or immune response to streptokinase. The clinical laboratory receives a blood specimen from the outpatient phlebotomy area of a hospital-based laboratory or a freestanding clinical laboratory. The specimen is accessioned, processed, and analyzed by a laboratory technologist using an immunoassay to detect streptokinase antibodies. Results are reported to the ordering clinician to inform potential immune-mediated reactions, interpret prior thrombolytic therapy effectiveness, or guide future use of streptokinase-containing agents. Typical sites of service include hospital outpatient laboratories, independent clinical laboratories, and reference laboratory facilities. Workflow steps: specimen collection and labeling, transport to laboratory, accessioning, performance of the streptokinase antibody assay, result verification by a laboratory director or pathologist, and electronic delivery of the report to the ordering provider.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier submitted | Default status when no other modifier applies |
11 | Professional component |