Summary & Overview
CPT 86704: Hepatitis B Core Antibody Laboratory Test
CPT code 86704 represents the laboratory test for hepatitis B core antibody (HBcAb), a critical component in the screening and diagnosis of hepatitis B infection. This test is widely used across the United States in both physician offices and independent laboratories, forming part of standard infectious disease serology panels. The code is recognized by major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, ensuring broad coverage for patients undergoing hepatitis B screening.
This publication provides a comprehensive overview of CPT code 86704, including payer coverage, clinical context, and its role in hepatitis B screening protocols. Readers will gain insight into current policy updates, typical billing practices, and how this code fits within broader hepatitis B testing panels. The summary also highlights relevant modifiers, associated taxonomies, and ICD-10 diagnoses commonly linked to this code, offering a clear understanding of its application in preventive care, especially for pregnant women and other at-risk populations. Additionally, related CPT codes frequently billed alongside 86704 are discussed, providing context for laboratory workflows and reimbursement considerations. The information presented is designed to inform healthcare professionals, billing specialists, and policy analysts about the national landscape for hepatitis B core antibody testing.
CPT Code Overview
CPT code 86704 is used to report laboratory testing for the presence of hepatitis B core antibody (HBcAb), which is a key marker in the diagnosis and management of hepatitis B infection. This test is classified under infectious disease serology and is typically performed in a laboratory setting, such as a physician office or an independent laboratory. The detection of HBcAb provides important information about a patient's exposure to hepatitis B virus and is commonly utilized in screening panels for hepatitis B infection.
Clinical & Coding Specifications
Clinical Context
A patient presents to a physician office or independent laboratory for screening or evaluation of Hepatitis B infection. This scenario often involves pregnant women undergoing routine prenatal screening, or individuals at risk for Hepatitis B exposure. The provider orders laboratory serology testing, including the Hepatitis B core antibody (total), to assess prior or current infection. The workflow includes specimen collection, laboratory analysis, and reporting of results to the ordering provider for clinical interpretation.
Coding Specifications
- Modifier
33: Used to indicate a preventive service. Medicare recognizes modifier33for preventive services, including Hepatitis B virus (HBV) screening with CPT code86704, when rendered to eligible patients.
| Modifier Code | Description |
|---|---|
33 | Preventive service — Medicare recognizes modifier 33 for preventive services including HBV screening (CPT code 86704) when rendered to eligible patients |