Summary & Overview
CPT 86723: Serum Immunoassay for Antibodies to Listeria monocytogenes
CPT code 86723 identifies a laboratory immunoassay that detects antibodies to Listeria monocytogenes in patient serum. As a targeted serologic test, it aids clinical diagnosis of suspected listeriosis and may inform public health investigations. Nationally, accurate coding for specialized infectious disease serology supports consistent claims processing and epidemiologic tracking.
This analysis covers major national payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for antibody testing against Listeria, typical sites of service for the assay, and the common payer landscape affecting coverage and billing. The publication also outlines available benchmarks, relevant policy updates where applicable, and operational considerations for laboratories and billing teams.
The content is intended for laboratory managers, coding and billing professionals, and compliance officers who need clear, code-specific guidance. Data not available in the input is identified where applicable; the focus remains on explaining the code's clinical purpose, typical use cases, and which payers are most relevant at the national level.
Billing Code Overview
CPT code 86723 describes an immunoassay performed by a laboratory analyst to detect antibodies to Listeria monocytogenes in a patient's serum. This test evaluates the patient’s immune response to exposure or infection with Listeria and supports clinical diagnosis when listeriosis is suspected.
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Service type: Serologic immunoassay (antibody testing)
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Typical site of service: Clinical laboratory or hospital laboratory (ambulatory laboratory collection sites and inpatient hospital labs)
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Clinical & Coding Specifications
Clinical Context
A 36-year-old pregnant woman presents to an outpatient infectious disease clinic with fever, flu-like symptoms, and a history of recent consumption of unpasteurized dairy. The obstetrician requests serologic testing to evaluate for Listeria monocytogenes exposure due to concern for maternal listeriosis and potential fetal risk. A phlebotomy technician collects a serum specimen which is sent to the hospital clinical laboratory. The laboratory analyst performs an immunoassay to detect serum antibodies to Listeria monocytogenes (CPT 86723). Results are reported to the ordering provider with interpretation, and positive serology prompts coordination with obstetrics for further clinical management and possible confirmatory testing (culture or PCR) and fetal monitoring. Typical site of service is an outpatient laboratory or hospital clinical laboratory receiving specimens from clinic, emergency department, or inpatient wards.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing separately for the professional interpretation or reporting by a pathologist/clinical laboratory director if reporting is split from technical component |
TC |