Article Detail - JE Part B
Proper Billing of Tuberculosis Test, CPT code 86481
Noridian is aware that some laboratories may be miscoding a different tuberculosis test that does not require cell enumeration by improperly using CPT code 86481.
There are two CPT codes for Interferon Gamma Release Assay tuberculosis tests:
- 86480: Tuberculosis test, cell mediated immunity antigen response measurement; of gamma interferon should be reported for tuberculosis (TB) testing by ELISA technique-based cell-mediated immunity measurement of gamma interferon antigen response.
- 86481: Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension, should be reported for an interferon gamma release assay that requires the enumeration of gamma interferon producing T-cells.
CPT code 86481 can only be reported for a test that includes the following steps/elements:
- Isolate peripheral blood mononuclear cells (PBMCs) from whole blood.
- Wash and standardize cell number.
- Quantification of IFN-gamma secreting cells.
When the test does NOT meet the requirements provided above, then CPT code 86480 must be reported.