Summary & Overview

CPT 86707: Hepatitis B e Antibody Immunoassay

CPT code 86707 denotes a laboratory immunoassay for hepatitis B e antibody (anti-HBe), a serological test used to assess hepatitis B infection status and the patient’s immune response. This code matters nationally because hepatitis B testing is a common component of infectious disease evaluation, blood donor screening, and clinical management of patients with known or suspected hepatitis B virus exposure. Accurate coding for this assay supports appropriate clinical interpretation, surveillance, and payment for laboratory services.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. The analysis addresses how this test is billed across major commercial and federal payers and highlights areas where policy updates and coding guidance may affect coverage and reimbursement.

Readers will find concise benchmarks for service utilization, summaries of relevant payer policy positions where available, and clinical context explaining when an anti-HBe immunoassay is typically ordered. The piece also covers common billing considerations, typical places of service for the assay, and how this test fits into broader hepatitis B testing panels and clinical workflows. Data not available in the input will be noted as such where specific payer policy details or utilization metrics are not provided.

AetnaBlue Cross Blue ShieldCignaUnitedHealthcareMedicare86707CPThepatitis Bimmunoassaylaboratoryserologyinfectious diseaseclinical testing

Billing Code Overview

CPT code 86707 describes an immunoassay performed by a laboratory analyst to detect hepatitis B e antibody (anti-HBe) in a patient specimen, typically serum. This test is a serological immunoassay used to evaluate a patient’s hepatitis B infection status and immune response.

Service type: Laboratory immunoassay testing
Typical site of service: Clinical laboratory or hospital laboratory (specimen is typically serum)

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Clinical & Coding Specifications

Clinical Context

A 42-year-old outpatient presents to a primary care clinic for evaluation after routine hepatitis B serology screening showed an unclear hepatitis B e antigen/antibody profile. The clinician orders a hepatitis B e antibody immunoassay to determine whether the patient has evidence of recent or resolving infection and to help guide counseling and next-step testing. A phlebotomy technician collects a serum specimen; the specimen is labeled and transported to the clinical laboratory. A laboratory analyst performs the immunoassay on an automated platform and documents results in the laboratory information system. The final report is routed to the ordering provider, typically the primary care physician or an infectious disease specialist, for interpretation and management. Typical site of service is an outpatient clinic or hospital laboratory receiving outpatient specimens; the service type is a laboratory immunoassay (serology) performed by clinical laboratory personnel.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the professional component if the laboratory test has separately reportable professional interpretation (rare for automated serology).
`59`	Distinct procedural service	Use when the immunoassay is a distinct service from another procedure performed on the same day and not normally reported together.
`90`	Reference (outside) laboratory	Use when the specimen is sent to an outside reference laboratory for testing.
`91`	Repeat clinical diagnostic laboratory test	Use when the same test is repeated on the same day to obtain subsequent confirmed results.
`52`	Reduced services	Use when the service is partially reduced or not performed as described.
`53`	Discontinued procedure	Use when testing was discontinued after initiation for documented clinical reasons.
`59`	Distinct procedural service	Use when the immunoassay is a distinct service from another procedure performed the same day and not normally reported together.
`90`	Reference (outside) laboratory	Use when the specimen is forwarded to an external lab for performance.
`91`	Repeat clinical diagnostic laboratory test	Use when a repeat assay is performed to confirm unexpected results.
`26`	Professional component	Use when only the professional component is billed separate from the technical component.

Taxonomy Code	Specialty	Notes
207RH0000X	Infectious Disease	Specialists who order and interpret hepatitis serologies in complex cases.
207Q00000X	Family Medicine	Primary care providers who commonly order screening and diagnostic hepatitis panels.
207L00000X	Internal Medicine	Hospital and clinic-based internists managing hepatitis testing and follow-up.
207K00000X	General Practice	Clinicians performing routine screening and ordering lab tests.
332B00000X	Pathology/Laboratory Medicine	Laboratory medicine specialists overseeing test performance and quality control.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`B16.9`	Acute hepatitis B without hepatic coma	Evaluates serologic markers including hepatitis B e antibody to assess infectivity and acute course.
`B18.1`	Chronic viral hepatitis B without delta-agent	`86707` can assist in monitoring serologic changes and assessing viral activity in chronic infection.
`Z11.59`	Encounter for screening for other viral diseases	Used when screening asymptomatic patients for hepatitis B markers including e antibody.
`Z20.820`	Contact with and (suspected) exposure to hepatitis B	Testing for `86707` may be indicated after known exposure to evaluate infectivity.
`O98.511`	Viral hepatitis B in pregnancy, first trimester	Pregnant patients may require hepatitis B serologic testing including e antibody as part of prenatal care.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`86704`	Hepatitis B core antibody; total (e.g., IgG and IgM)	Often ordered alongside `86707` to evaluate overall hepatitis B serologic profile.
`86706`	Hepatitis B surface antibody	Commonly performed with `86707` to assess immunity and stage of infection.
`87340`	Hepatitis B surface antigen (HBsAg)	Frequently ordered with `86707` to detect active hepatitis B infection.
`80061`	Lipid panel	Example of other common laboratory tests that may be ordered during the same outpatient visit but not directly related; billed separately.
`99000`	Handling and/or conveyance of specimen to laboratory	Example administrative/component code associated with specimen transport when billed (facility-dependent).