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.

Last Updated Oct 03 , 2024