Summary & Overview
CPT 86632: Chlamydia Antibody IgM Serologic Test
CPT code 86632 represents a serologic laboratory test for chlamydia IgM antibodies, used to detect recent Chlamydia trachomatis infection. The test is clinically important because chlamydial infections are a common sexually transmitted disease and can also cause pneumonia and conjunctivitis; identifying recent infection can inform clinical management and public health surveillance. Nationally, laboratory diagnostic codes like 86632 matter because they underpin billing, laboratory reporting, and epidemiologic tracking across healthcare settings.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the test, typical sites of service (clinical and hospital laboratories), and the service type (serologic diagnostic test, technical component). The publication also outlines benchmarking and coverage considerations where available, common billing modifiers, and how this code relates to laboratory workflows and reporting requirements.
This report is written for a national audience and provides concise guidance on what CPT code 86632 represents, why it is used, and what to expect when it appears on a laboratory service line. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 86632 describes a laboratory test performed by a lab analyst to detect chlamydia antibody IgM in serum. The test identifies IgM antibodies that generally indicate recent or acute Chlamydia trachomatis infection, which can present as a sexually transmitted infection and can also cause pneumonia and conjunctivitis in certain patient groups.
Service Type: Serologic laboratory diagnostic test (technical component)
Typical Site of Service: Clinical laboratory or hospital laboratory
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 22-year-old sexually active female presents to an outpatient clinic with new-onset purulent cervical discharge and lower abdominal cramping. The clinician obtains a detailed sexual history, performs a pelvic exam, and collects blood for serologic testing. The laboratory performs a serologic assay for chlamydia IgM antibody (86632) to assess recent Chlamydia trachomatis infection, particularly when nucleic acid amplification testing (NAAT) from genital swabs is unavailable, the patient has systemic signs, or there is concern for disseminated or extra-genital infection (for example, conjunctivitis or pneumonia in neonates/infants). Typical workflow: specimen collection (serum) → specimen labeled and sent to the clinical laboratory → lab analyst performs the 86632 IgM assay → results reported to ordering provider and entered into the electronic medical record. Typical site of service: outpatient clinic, hospital laboratory, public health laboratory, or reference laboratory. Typical patient scenarios also include neonatal conjunctivitis evaluation, evaluation of suspected recent sexual exposure in adolescents/young adults, and evaluation of atypical pneumonia where chlamydial species is considered.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |