CPT code 86695 represents a laboratory immunoassay to detect antibodies to herpes simplex virus type 1 (HSV‑1) in serum or cerebrospinal fluid. As a commonly ordered infectious disease serology test, it plays a role in diagnosing HSV‑1 infection and informing clinical decisions for neurologic and mucocutaneous presentations. Nationally, accurate coding of serologic assays such as CPT code 86695 affects claims processing, lab reimbursement, and surveillance data used by public health entities.

Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the assay, common sites of service, and the typical service type. The publication summarizes payer coverage patterns, coding and billing considerations relevant to outpatient and inpatient laboratory settings, and benchmarking points where available. It also highlights policy and documentation elements that commonly influence reimbursement decisions for HSV‑1 antibody testing.

This briefing is intended for laboratory managers, coding and billing staff, clinician leaders, and policy analysts seeking a national-level reference on CPT code 86695, its clinical utility, and the factors that commonly affect payer adjudication and reporting for serologic HSV‑1 testing.