CPT code 86804 represents a laboratory confirmatory assay for hepatitis C virus (HCV) antibodies, typically performed after an initial reactive screening test to establish serologic evidence of HCV exposure. This confirmatory testing plays a key role in diagnosing past or present infection and guiding further clinical evaluation, including RNA testing and linkage to care. Nationally, standardized reporting and coding for confirmatory HCV antibody assays affect surveillance, care pathways, and laboratory billing practices.

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 confirmatory HCV antibody testing, expected sites of service, and the typical laboratory workflow associated with this procedure. The publication also outlines common billing considerations, frequently used modifiers (provided in the input), and where CPT code 86804 fits within laboratory service lines.

This summary provides a practical reference for billing and coding staff, laboratory managers, and policy analysts interested in how confirmatory serologic assays for HCV are captured in claims and the implications for clinical follow-up and public health reporting. Data not available in the input is noted where relevant.