Summary & Overview
CPT 86692: Hepatitis D (Delta) Antibody Immunoassay
CPT code 86692 identifies a laboratory immunoassay for antibodies to hepatitis D (delta agent). This diagnostic test supports clinical evaluation of suspected hepatitis D infection in patients with hepatitis B co-infection or unexplained hepatic dysfunction and has implications for patient management and public health surveillance. Nationally, accurate coding for serologic testing influences claims adjudication, lab reporting, and epidemiologic tracking.
Key payers included in the coverage discussion are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of what the code represents, typical clinical contexts for use, and what to expect in terms of service setting. The publication summarizes common billing considerations and provides benchmarking context where available. It also outlines clinical relevance, including when hepatitis D antibody testing is likely to be ordered and how it integrates with broader viral hepatitis workups.
This summary is intended for a national audience of coding professionals, laboratory managers, and policy analysts seeking a concise reference to the purpose and application of CPT code 86692 and the types of payer coverage and clinical scenarios in which the test is used. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 86692 describes an immunoassay performed by a laboratory analyst to evaluate serum for antibodies to hepatitis, delta agent (hepatitis D). The service tests a patient’s blood specimen to detect immune response indicative of current or prior infection with hepatitis D virus.
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Service type: Laboratory diagnostic immunoassay
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Typical site of service: Clinical laboratory or hospital laboratory setting
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient with chronic hepatitis B infection presents for screening after newly reported elevated liver enzymes and risk factors for blood-borne pathogens (history of injection drug use and unprotected sexual exposure). The clinician orders serologic testing for hepatitis D virus (HDV) to determine whether co-infection or superinfection explains worsening hepatic inflammation. The patient has blood drawn in an outpatient phlebotomy area of a hospital outpatient laboratory. The lab analyst performs an immunoassay to detect anti-HDV antibodies in the patient’s serum (CPT 86692). Results are reviewed by the laboratory director and reported to the ordering provider via the electronic health record. If positive, reflex molecular testing for HDV RNA or referral to hepatology is typical for further evaluation and management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier—routine billing | Use when no other modifier applies and full payment is claimed. |
11 | Active/primary surgeon or billing provider | Rare for laboratory codes; use if required by specific payer to indicate primary performing provider. |