Summary & Overview
CPT 86706: Hepatitis B Surface Antibody Immunoassay
CPT code 86706 represents a laboratory immunoassay for hepatitis B surface antibody, a widely used serologic test to determine immunity from prior infection or vaccination. Nationally, this code is important for preventive care, occupational health screening, pre-transplant evaluations, and public health surveillance. It is commonly billed by clinical and hospital laboratories when processing serum specimens.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for ordering the test, typical sites of service, and the common scenarios in which the assay is used. The publication also outlines benchmark considerations, payer coverage patterns, and relevant policy updates that affect laboratory testing reimbursement and coding practices.
The document is intended to help billing staff, laboratory managers, and policy analysts understand how CPT code 86706 is used in practice, what payers typically encounter, and where to look for further guidance on coverage and documentation. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 86706 describes an immunoassay performed by a laboratory analyst to detect hepatitis B surface antibody, typically using a patient’s serum specimen. This test assesses the presence of antibodies indicating immunity to hepatitis B, whether from prior infection or vaccination.
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Service type: Laboratory diagnostic immunoassay
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Typical site of service: Clinical laboratory or hospital laboratory setting
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Clinical & Coding Specifications
Clinical Context
A 28-year-old adult presents to an outpatient primary care clinic for routine employment screening and vaccination assessment. The clinician orders serologic testing to determine immunity to hepatitis B following prior vaccination series. A phlebotomist draws a serum specimen which is sent to the medical laboratory. The laboratory technologist performs an immunoassay to detect hepatitis B surface antibody (anti-HBs) using automated analyzers. Results are reported in international units per liter (IU/L) and reviewed by the ordering provider to confirm immunity status and guide any need for booster vaccination or further evaluation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component, applicable if separate professional and technical billing occurs for serology interpretation (rare for immunoassays). |
59 | Distinct procedural service | Use if this test is performed and billed separately from other distinct laboratory services on the same day that are not normally bundled. |