Summary & Overview

CPT 86682: Immunoassay for Helminth Antibodies in Serum or CSF

CPT code 86682 denotes a laboratory immunoassay to detect antibodies to helminths in serum or cerebrospinal fluid. This serologic test supports diagnosis of parasitic worm infections when direct detection is difficult or when assessing immune response. Nationally, accurate coding and interpretation of serology for helminths affect epidemiologic surveillance, appropriate clinical management, and lab reporting pathways.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for ordering this test, typical sites of service where the assay is performed, and the common modifiers associated with laboratory services. The publication summarizes reimbursement and coverage considerations at a high level, highlights coding clarity for billing teams, and outlines where data was not available in the input.

This resource is aimed at billing professionals, laboratory managers, and clinicians who need a concise reference to the clinical purpose and billing identity of CPT code 86682. It clarifies what the code represents, why it matters in national practice, and what operational elements (service type and typical sites) are associated with ordering and processing the test. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare86682CPTlaboratoryimmunoassayparasitologyhelminthserologyclinical-testing

Billing Code Overview

CPT code 86682 describes an immunoassay performed by a laboratory analyst to detect antibodies to a helminth (parasitic worm) in a patient’s serum or cerebrospinal fluid (CSF). This test is used to identify antibody responses indicative of helminth infection when clinical suspicion or exposure history warrants serologic evaluation.

Service Type: Laboratory diagnostic immunoassay

Typical Site of Service: Clinical laboratory or hospital laboratory (specimen obtained in outpatient clinic, emergency department, or inpatient setting and sent to a lab for testing).

Clinical & Coding Specifications

Clinical Context

A middle-aged patient presents to an outpatient infectious disease clinic with subacute neurologic symptoms (headache, paresthesias) and a recent history of freshwater exposure during international travel. The clinician orders laboratory testing to evaluate for parasitic helminth infection. A venous serum specimen (or cerebrospinal fluid if neurological involvement is suspected) is collected and sent to the clinical laboratory. The laboratory analyst performs an immunoassay to detect antibodies to a helminth not enumerated by other specific test codes. Results are reported to the ordering provider and incorporated into the diagnostic workup to guide additional testing (e.g., stool ova and parasites, specific helminth serologies) and specialty referral if positive. Typical site of service is an outpatient laboratory or hospital clinical laboratory; specimen collection occurs in clinic, emergency department, or inpatient setting as clinically indicated.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the professional interpretation component if the laboratory test includes a technical and professional component and the provider performed the interpretation.
`59`	Distinct procedural service	Use when this test is distinct and separate from other services on the same day (e.g., a different specimen or unrelated lab test).
`90`	Reference (outside) laboratory	Use when the specimen is sent to an outside/reference laboratory and billing must indicate testing performed by another lab.
`91`	Repeat clinical diagnostic laboratory test	Use when the same immunoassay is repeated on the same day to confirm unexpected results.
`52`	Reduced services	Use when the test is partially reduced or not fully performed compared to the full CPT service.
`53`	Discontinued procedure	Use when specimen collection or testing was started but discontinued for documented clinical reasons.
`90`	Reference (outside) laboratory	Use when the laboratory testing is performed by an outside reference laboratory and billing must reflect that arrangement.
`TC`	Technical component	Use when billing only the technical component (laboratory instrumentation, reagents, and technical personnel) and the reporting clinician is separate.
`QX`	Qualified non-physician practitioner service with modifier QK/QM	Use when requirements for qualified non-physician practitioner are met and additional modifier pairing is required by payors.
`QY`	Medical direction of two, three, or four ancillary personnel	Use when a physician medically directs multiple laboratory personnel performing the tests.

Taxonomy Code	Specialty	Notes
207RH0000X	Infectious Disease	Specialists ordering and interpreting serologic testing for parasitic infections.
208000000X	Pathology	Pathologists overseeing laboratory testing, interpretation, and reporting.
363L00000X	Laboratory – Clinical	Clinical laboratory directors and medical technologists performing immunoassays.
2080000006X	Neurology	Neurologists may order CSF antibody testing when neurologic helminth infection is suspected.
208D00000X	Internal Medicine	Hospitalists and internists ordering initial diagnostic testing for systemic symptoms.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`B83.9`	Malaria, unspecified	Serologic testing may be used in supportive diagnosis when blood smears are inconclusive or for travel-related parasitic evaluation.
`B77.9`	Ascariasis, unspecified	Helminth infections of the intestines commonly prompt antibody testing when stool exams are negative or in systemic presentations.
`B76.9`	Schistosomiasis, unspecified	Schistosomal infections can present with systemic or neurologic signs; serology on serum or CSF may aid diagnosis.
`B79.9`	Filariasis, unspecified	Suspected filarial infection with systemic symptoms may be evaluated with antibody testing.
`A08.4`	Viral and other specified intestinal infections	Included for broader intestinal infectious workup when helminthic etiology is considered.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`81025`	Urinalysis, non-automated with microscopy	Performed as part of an initial laboratory evaluation when systemic parasitic infection is considered; complementary screening.
`87086`	Culture, bacterial, screening for enteric pathogens	May be ordered alongside stool testing when intestinal helminth infection or enteric co-infection is suspected.
`87210`	Smear, primary source with interpretation for infectious agents (e.g., wet mount)	Direct microscopic examination of stool or CSF can be performed before or in parallel with serologic testing.
`87250`	Infectious agent immunofluorescent study	Alternative laboratory method for detecting certain parasitic antigens or organisms when available.
`88305`	Surgical pathology, gross and microscopic examination	Used when tissue biopsy is obtained to identify parasitic organisms histologically in atypical presentations.