Summary & Overview

CPT 86768: Salmonella Antibody Immunoassay

CPT code 86768 represents a laboratory serologic immunoassay to detect antibodies to Salmonella in a patient’s serum. This assay supports clinical diagnosis of Salmonella exposure or infection and is commonly used in hospital and outpatient laboratory settings. Nationally, accurate coding for serologic tests like 86768 matters for clinical care pathways, public health surveillance, and administrative reporting.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for Salmonella antibody testing, common sites of service, and the coding implications for laboratory billing. The publication summarizes typical use cases, expected service lines, and payer coverage considerations where available. It also highlights benchmarks and policy considerations relevant to laboratory services that support infectious disease diagnosis.

This summary provides a national perspective on the role of CPT code 86768, what it signifies clinically, and the types of operational and payer topics that affect its use.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 86768Salmonella antibodyserologylaboratoryimmunoassayinfectious diseaseclinical laboratorylab billingdiagnostic testing

Billing Code Overview

CPT code 86768 describes an immunoassay performed by a laboratory analyst to detect antibodies to Salmonella in a patient’s serum. This test evaluates the immune response to Salmonella infection and is used in clinical and public health settings to support diagnosis of exposure or infection.

Service Type: Laboratory – Serologic Immunoassay

Typical Site of Service: Clinical laboratory or hospital laboratory

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult presenting to an outpatient clinic or emergency department with fever, abdominal pain, diarrhea, or a recent suspected foodborne illness after travel or an exposure event. The clinician suspects Salmonella infection or wants to assess prior exposure for epidemiologic or diagnostic confirmation. A blood specimen is collected by phlebotomy and sent to the clinical laboratory. The laboratory analyst performs an immunoassay to evaluate the patient’s serum for antibodies to Salmonella (CPT 86768). Results are reported to the ordering provider and documented in the patient chart; if positive or suggestive, culture or molecular testing of stool or blood may be ordered and public health authorities notified per local requirements. Typical sites of service include hospital outpatient laboratories, independent clinical laboratories, urgent care centers with on-site lab services, and inpatient hospital laboratories when serologic confirmation is necessary for patient management or epidemiologic investigation.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the professional interpretation component if the laboratory sends images or consults requiring a professional service distinct from the technical lab processing.
`59`	Distinct procedural service	Use to indicate a laboratory service is distinct/separate from other services on the same day when appropriate (e.g., separate from culture or other serologies).
`90`	Reference (outside) lab	Use when the specimen is sent to an outside reference laboratory and the billing reflects that arrangement.
`91`	Repeat clinical diagnostic lab test	Use when the same antibody immunoassay is repeated on the same day for verification of results.
`TC`	Technical component	Use when billing only the technical component for the laboratory processing when professional interpretation is billed separately.
`QX`	Service performed by CRNA (modifier for certain practitioner requirements)	Use only when applicable regulatory rules require this modifier for the billing practitioner type performing the service.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services provided in part-time	Use when applicable to indicate services furnished by these clinicians per payer rules (use only if relevant to lab ordering or billing relationships).
`22`	Increased procedural services	Use when the laboratory documents and justifies substantially greater work (rare for standardized immunoassays; typically not applicable).
`52`	Reduced services	Use when the test performed is partially reduced or not completed for documented clinical reasons.
`53`	Discontinued procedure	Use if specimen collection or testing was started but discontinued due to patient condition or specimen inadequacy.

Taxonomy Code	Specialty	Notes
207Q00000X	Pathology & Laboratory Medicine	Clinical laboratory directors and pathologists who oversee serologic testing and result interpretation.
208000000X	Clinical Laboratory	Laboratory technologists and analysts who perform immunoassays such as `CPT 86768`.
363A00000X	Phlebotomy	Providers or technicians responsible for specimen collection and handling prior to testing.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`86631`	Antibody; Hepatitis B surface, qualitative or semiquantitative	Often ordered concurrently when evaluating infectious causes or screening for transfusion-related risks; represents other serologic testing workflow parallels.
`87491`	Infectious agent detection by nucleic acid (e.g., Salmonella), amplified probe technique, single specimen	Molecular stool or blood testing that may be ordered after or alongside serology for direct pathogen detection and confirmation of acute infection.
`87045`	Culture, bacterial; stool, selective media	Stool culture is commonly performed to isolate Salmonella organisms when serology suggests infection; complements serologic results for definitive diagnosis.
`80053`	Comprehensive metabolic panel	Basic metabolic testing frequently performed in patients with systemic symptoms to assess organ function alongside infectious disease workup.
`99000`	Handling and/or conveyance of specimen for transfer from the physician's office to a laboratory	May be billed in contexts where specimen transport is a distinct billable service in the clinical workflow associated with sending serum for `CPT 86768`.