Summary & Overview
CPT 86611: Bartonella Antibody Immunoassay
CPT code 86611 designates a laboratory immunoassay to detect antibodies to Bartonella species. This serologic test is used to support diagnosis of Bartonella infection, a nationally relevant clinical concern due to its variable presentation and potential for serious complications in certain populations. Accurate laboratory coding for this test affects clinical workflow, claims processing, and public health surveillance.
Key payers addressed in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national overview of how CPT code 86611 is used in practice, common payer considerations, and the clinical context for ordering the test.
Readers will find benchmarks and observed utilization patterns, relevant policy updates affecting laboratory reimbursement, and clinical context that explains when an immunoassay for Bartonella antibodies is clinically indicated. Where detailed input data is missing, the text specifies that data are not available in the input. The summary aims to inform billing staff, laboratory managers, and health policy analysts about coding implications, payer coverage landscape, and the role of this diagnostic assay in patient care.
Billing Code Overview
CPT code 86611 describes an immunoassay performed by a laboratory analyst to detect antibodies to the bacterium Bartonella in a patient's blood. This service is a laboratory diagnostic test used to evaluate serologic evidence of Bartonella infection.
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Service type: Laboratory immunoassay
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Typical site of service: Clinical laboratory or hospital laboratory setting
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 34-year-old patient presents to an outpatient infectious disease clinic with a 3-week history of fever, intermittent headache, and new onset of regional lymphadenopathy after a reported cat scratch. The ordering clinician documents suspected Bartonella henselae infection based on exposure history and clinical signs. A venous blood specimen is collected in the clinic phlebotomy area and sent to the hospital reference laboratory. The lab analyst performs an immunoassay to detect anti-Bartonella antibodies using an enzyme immunoassay (EIA) or indirect immunofluorescence assay (IFA). Results are reported to the ordering provider; serology supports acute or prior infection and guides further management such as confirmatory testing, additional microbiology studies, or targeted therapy. Typical site of service: outpatient clinic or hospital laboratory (reference lab). Service type: diagnostic serology/immunoassay performed by clinical laboratory personnel under CPT 86611.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation and report by a pathologist or laboratory physician separate from the technical assay. |
TC |