Summary & Overview
CPT 86653: Immunoassay for Saint Louis Encephalitis Virus Antibodies
CPT code 86653 identifies a laboratory immunoassay for antibodies to Saint Louis encephalitis virus (SLEV) in serum or cerebrospinal fluid. This serologic test is used in the clinical evaluation of patients with suspected SLEV infection, which has public health significance due to its potential for neuroinvasive disease. Accurate laboratory diagnosis informs clinical management and surveillance efforts nationally.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines how the code is used across clinical laboratories and hospital laboratories, where such testing is typically performed.
Readers will find a concise overview of the clinical purpose of the test, expected sites of service, and the payer mix considered. The content highlights billing context and common modifiers provided in the input. Where input data is missing—such as provider taxonomies, associated ICD-10 diagnoses, detailed payer policies, and related codes—the text notes that data is not available in the input. The piece serves as a national reference for healthcare administrators, laboratory managers, and billing professionals seeking a clear description of CPT code 86653, its clinical role, and the payer landscape relevant to serologic testing for SLEV.
Billing Code Overview
CPT code 86653 describes an immunoassay performed by a laboratory analyst to detect antibodies to Saint Louis encephalitis virus (SLEV) in a patient’s serum or cerebrospinal fluid. This test evaluates the presence of specific antiviral antibodies to support diagnosis of SLEV infection.
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Service type: Laboratory infectious disease serology
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Typical site of service: Clinical laboratory, hospital laboratory, or reference laboratory where blood or cerebrospinal fluid specimens are analyzed
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient presents to the emergency department during late summer with acute onset fever, headache, photophobia, neck stiffness, and mild confusion after recent outdoor activities in an area with known mosquito-borne encephalitis activity. The clinician orders a neurological evaluation, lumbar puncture, and serum infectious disease serology, including testing for Saint Louis encephalitis virus (SLEV).
The laboratory receives paired serum samples (acute and convalescent) and/or cerebrospinal fluid (CSF). A clinical laboratory scientist performs an immunoassay to detect SLEV-specific IgM and/or IgG antibodies (CPT 86653). Results are reported to the ordering provider and incorporated into the infectious disease consult and public health reporting workflow as required by local health departments. Typical turnaround time varies from same-day to several days depending on confirmatory testing and public health referral.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional interpretation of a laboratory result provided separately from the technical component. |
TC |