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CPT 86704: Total Hepatitis B Core Antibody Immunoassay
CPT code 86704 identifies a laboratory immunoassay for total hepatitis B core antibodies (anti-HBc total), detecting all immunoglobulin classes to determine prior or current exposure to hepatitis B virus. This code is widely used in screening and diagnostic workflows, including routine prenatal screening and public health surveillance, making it clinically and operationally significant across healthcare settings nationwide. Key commercial and governmental payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will gain a concise understanding of what the code represents, how it fits within common hepatitis B testing panels, typical sites of service, and the clinical contexts in which the test is ordered. The publication also outlines common companion laboratory codes and frequently billed pairings used in hepatitis B screening strategies, payer coverage considerations, and billing scenarios relevant to clinicians, laboratory managers, and coding professionals. Data not available in the input is noted where specific reimbursement benchmarks or payer policy details are required.
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Billing Code Overview
CPT code 86704 describes an immunoassay performed by a laboratory analyst to detect total hepatitis B core antibodies in a patient's specimen, typically serum. The test reports a total antibody result that includes all immunoglobulin types, used to assess prior or current exposure to hepatitis B virus.
Service Type: Clinical laboratory test (serology/immunoassay)
Typical Site of Service: Clinical laboratory or hospital laboratory
National Reimbursement Benchmarks
Commercial reimbursement for CPT 86704 centers on BUCA’s average of $28 as the market mid-line, with notable variation among major carriers. Blue Cross Blue Shield displays the highest central tendency at a $35.9 median and a wide spread, while Aetna and Cigna sit closer to BUCA on average ($13.4 and $13.2 respectively). UnitedHealth Group posts a lower median ($7.2) and mean ($10.6), indicating a cluster of lower rates relative to the overall commercial average.
Dispersion measured by the interquartile range (P75–P25) highlights where rates are tight or wide: Blue Cross Blue Shield’s IQR is $16.1 (wideest), BUCA’s IQR is $12.5 (moderately wide), Cigna’s IQR is $10.6, UnitedHealth Group’s IQR is $6.6, and Aetna’s IQR is $5.6 (tightest). This indicates Blue Cross Blue Shield and BUCA contribute most to market variability, while Aetna and UnitedHealth Group are relatively constrained.