Summary & Overview
CPT 86668: Immunoassay for Antibodies to Francisella tularensis
CPT code 86668 represents a laboratory immunoassay for detection of antibodies to Francisella tularensis, the bacterium that causes tularemia. As a diagnostic serologic test, it supports clinical confirmation of infection, public health case finding, and epidemiologic surveillance. Nationally, use of this code matters for tracking specialty infectious disease testing volumes and for laboratory reimbursement and preparedness planning for rare but high-consequence pathogens.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for serologic testing for tularemia, the typical sites where the service is performed (clinical and hospital laboratories), and the primary reasons the test is ordered. The publication also outlines expected benchmarks and policy-related considerations relevant to laboratory testing reimbursement and coding practice. Where specific payer policies exist, the report summarizes differences in coverage determinations and billing requirements. For items not provided in the input, such as associated taxonomies, specific ICD-10 pairings, and detailed payer fee benchmarks, the text indicates that data is not available in the input.
This summary is intended to equip laboratory managers, billing professionals, and health policy stakeholders with a clear, national-level understanding of CPT code 86668, its clinical role, and the payer landscape relevant to ordering and billing for serologic testing for Francisella tularensis.
Billing Code Overview
CPT code 86668 describes an immunoassay performed by a laboratory analyst to detect antibodies to the bacterium Francisella tularensis in a patient’s serum. This test is a serologic assay used to evaluate exposure or immune response to the organism that causes tularemia.
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Service type: Laboratory immunoassay/serology testing
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Typical site of service: Clinical laboratory or hospital laboratory (inpatient or outpatient specimen processing)
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Clinical & Coding Specifications
Clinical Context
A patient presents to an outpatient infectious disease clinic or public health laboratory with febrile illness after potential exposure to wild rabbits, ticks, or other vectors in an endemic area. The clinician documents symptoms such as fever, regional lymphadenopathy, ulcerative skin lesion, or respiratory symptoms suggestive of pneumonic tularemia. A serum specimen is collected by nursing staff or phlebotomy and sent to the laboratory for serologic testing. In the microbiology/immunology laboratory the lab analyst performs an immunoassay to detect antibodies to Francisella tularensis (CPT 86668). Results are reported to the ordering clinician and local public health authorities if positive or suspicious. Typical sites of service include hospital outpatient laboratories, independent reference laboratories, public health laboratories, and infectious disease clinics. The clinical workflow includes specimen collection, specimen accessioning, assay performance, quality control, result verification by a qualified laboratorian, and electronic or paper reporting to the provider and, where required, to public health departments.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing separately for the professional interpretation or reporting component performed by a qualified physician or laboratorian when the technical component is billed by another entity. |