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CPT 86694: HSV Nonspecific Antibody Immunoassay
CPT code 86694 represents a laboratory immunoassay for detection of antibodies to a nonspecific type of herpes simplex virus (HSV) in serum. This serologic test is used to assess prior exposure or immune response to HSV and is commonly ordered when clinical signs, symptoms, or epidemiologic history raise concern for herpes infection. Nationally, serologic HSV testing has clinical and billing implications because it informs diagnosis, counseling, and infection-control decisions across outpatient clinics, hospital laboratories, and public health settings.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The content summarizes how CPT code 86694 is described in claims, the clinical context for ordering the test, and typical sites of service where the assay is performed.
Readers will learn the clinical role of the assay, where the service is typically delivered, and which major payers underwrite laboratory testing of this type. The publication provides benchmarks and policy-relevant context about laboratory serology billing patterns, coding considerations when ordering serologic HSV tests, and operational notes for laboratory-based services. Data not available in the input will be identified as such in detailed sections.
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Billing Code Overview
CPT code 86694 describes an immunoassay performed by a laboratory analyst to detect antibodies to a nonspecific type of herpes simplex virus (HSV) in a patient’s serum. The service is a laboratory diagnostic test used to evaluate prior exposure or immune response to HSV when clinical correlation is needed.
Service type: Laboratory immunoassay, serology
Typical site of service: Clinical laboratory or hospital laboratory (specimen collected in an outpatient clinic, physician office, or hospital setting and processed in a lab)