Summary & Overview

CPT 86727: LCMV Antibody Immunoassay

Headline: CPT code 86727: Laboratory Immunoassay for Lymphocytic Choriomeningitis Virus Antibodies

Lead: CPT code 86727 designates a laboratory immunoassay used to detect antibodies to lymphocytic choriomeningitis virus (LCMV) in patient specimens, a targeted serologic test with public health and clinical relevance for diagnosing exposure or infection.

CPT code 86727 represents a specific laboratory immunoassay that identifies antibodies to lymphocytic choriomeningitis virus. This code is important nationally for clinicians, laboratories, and payers because it supports diagnosis and surveillance of a zoonotic viral infection that can have neurologic and systemic manifestations in humans. Accurate coding ensures appropriate tracking of utilization and facilitates reimbursement for specialized infectious disease testing.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides readers with a concise overview of clinical context, standard sites of service, commonly reported modifiers, and the role of this assay in diagnostic workflows. It also outlines typical billing considerations and what to expect in claims processing for specialized serologic tests.

Readers will learn the clinical purpose of the assay, where it is typically performed, and which payers commonly cover such services. Data not provided in the input—such as specific ICD-10 pairings, payer-specific reimbursement rates, or taxonomies—is noted as unavailable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 86727laboratoryimmunoassayinfectious diseaseserologylymphocytic choriomeningitis viruslab billingdiagnostic test

Billing Code Overview

CPT code 86727 describes an immunoassay performed by a laboratory analyst to detect antibodies to lymphocytic choriomeningitis virus in a patient specimen. This test is a serologic assay intended to identify immune response markers indicating current or prior infection with lymphocytic choriomeningitis virus.

Service type: Laboratory diagnostic immunoassay

Typical site of service: Clinical laboratory or hospital laboratory

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult or pediatric outpatient or inpatient who presents with possible exposure to rodents or who has signs compatible with viral central nervous system infection (fever, headache, meningismus, altered mental status) or systemic febrile illness of unclear etiology. The clinician collects a serum or cerebrospinal fluid specimen and orders an immunoassay for antibodies to lymphocytic choriomeningitis virus (LCMV) to evaluate for recent or prior infection. The specimen is received in the laboratory, accessioned, and processed by a medical laboratory scientist or immunology technologist who performs the serologic immunoassay (enzyme immunoassay or similar platform). Results are reviewed by the lab analyst or pathologist; positive or equivocal findings prompt reflex confirmatory testing, infectious disease consultation, and public health reporting if indicated. Typical workflow includes specimen collection, transport to the reference or hospital laboratory, performance of the 86727 immunoassay, result verification, and reporting to the ordering clinician.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the professional interpretation component separate from the technical lab work, if applicable in split-billing arrangements.
`TC`	Technical component	Use when reporting only the technical component (laboratory testing) performed by the facility.
`59`	Distinct procedural service	Use when a separate, distinct lab procedure is performed on the same day that is not typically bundled with `86727` and documentation supports separateness.
`90`	Reference (outside) lab	Use when the specimen is sent to an outside reference laboratory for performance of `86727`.
`91`	Repeat clinical diagnostic laboratory test (note: not listed in input)	Data not available in the input.
`53`	Discontinued procedure	Use if testing was started but discontinued for documented patient- or specimen-related reasons (rare for lab assays).
`22`	Increased procedural services	Use when extraordinary work or complexity for the lab analysis is documented and allowed by payor policy.
`52`	Reduced services	Use when a reduced testing service is performed and properly documented.
`90`	Reference (outside) lab	Use when testing is performed by an outside reference laboratory (duplicate of `90` entry avoided in practice; listed here as applicable).
`QX`	Ordering physician qualification (CA modifier set)	Use when applicable to credentialing requirements for durable outside services—apply per payer rules.

Taxonomy Code	Specialty	Notes
163W00000X	Infectious Disease	Physicians who order and interpret LCMV testing and manage results.
207K00000X	Pathology	Pathologists oversee laboratory diagnostic testing and result verification.
207L00000X	Clinical Laboratory	Clinical laboratory scientists and directors who perform and supervise the immunoassay.
208000000X	Pediatrics	Pediatricians ordering LCMV testing in children with suspected rodent exposure or CNS infection.
163P00000X	Public Health	Public health specialists involved when positive cases require reporting and epidemiologic investigation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`A83.9`	Viral encephalitis, unspecified	LCMV can cause encephalitis; testing with `86727` is clinically relevant when viral encephalitis is suspected.
`A84`	Japanese encephalitis	Represents viral encephalitis category; included as part of differential diagnosis for CNS viral infections.
`R50.9`	Fever, unspecified	Unexplained febrile illness after rodent exposure may prompt serologic testing for LCMV.
`G03.9`	Meningitis, unspecified	Meningeal syndromes with possible viral etiology may prompt `86727` testing.
`Z20.828`	Contact with and (suspected) exposure to other viral communicable diseases	Use when documenting known or suspected exposure to rodents or LCMV source prompting testing.
`P35.1`	Congenital cytomegalovirus infection (CMV) (note: example of congenital TORCH testing context)	LCMV is a congenital infection risk; testing may be part of workup in adverse fetal outcomes (use appropriate pregnancy-specific codes when relevant).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`86631`	Antibody; cytomegalovirus (CMV), IgG	Often ordered in differential serologic workups for viral causes of systemic illness and congenital infections.
`86762`	Antibody; hantavirus	Ordered when rodent-borne viral infection is suspected; may be performed alongside `86727` when exposure history suggests multiple zoonoses.
`86803`	Immunoassay for infectious agent antigen detection by enzyme immunoassay technique, multiple-step method	Related test methodology; laboratories performing `86727` may use similar platforms and workflows.
`86328`	Antibody; arbovirus panel (e.g., Eastern equine encephalitis)	May be part of an expanded encephalitis workup including `86727` when evaluating causes of viral encephalitis.
`87205`	Smear, primary source with interpretation for virus by immunofluorescence	Alternative or adjunct virologic diagnostic methods in CNS infection workups.