CPT^® 86235, Under Qualitative or Semiquantitative Immunoassays

The Current Procedural Terminology (CPT^®) code 86235 as maintained by American Medical Association, is a medical procedural code under the range - Qualitative or Semiquantitative Immunoassays.

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Summary

The lab analyst performs an assay to evaluate the patient’s serum for each antibody to an extractable nuclear antigen, also called ENA. Types of ENA antibodies include anti ribonuclear protein, called RNP or nRNP; anti Sjogren’s Syndrome A and B, called SS A and SS B; anti Smith, called Sm; and anti scleroderma, called Scl 70.

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ANA Profile coding question

This is a new test to our office and just want to do this correctly. The test includes 86235 x8, is it appropriate to apply a modifier? TIA... [ Read More ]

86235 to be billed with modifier 59,91 or QW

[b]response to 86235 (multiple charges)[/b] Hi rosamagana, 86235 is a procedure that can be representing many different antibodies. If they are different antibodies you would apply modifier 59 for t... [ Read More ]

86235 to be billed with modifier 59,91 or QW 86235 lab multiple times

As a diagnostic test lab, we are supposed to bill 86235 8 times for a test. My question is which modifier I should use? I have heard mixed info about using 91,59 or QW. Can some one please advise, wh... [ Read More ]

ANA Profile

ANA is coded with 86038. 86235 is a different kind of testing.... [ Read More ]

Coding 86235 and 83516

Billing these codes for labs done in provider office. Medicare pays but need help with commercial insurance. Looking for anyone that can help.... [ Read More ]

Modifer 59

I'd like to know this also, And i was thinking it should be 86235 X5 - 59 If anyone disagree's please correct !... [ Read More ]

86235

Good Morning ! I have a Claim back from our Billing dept. Here is what happened. Claim was sent in 86235 Mod 76 and they did this 5 times. (Extractable nuclear antigen, antibody to, any method (eg,... [ Read More ]

Lab billling and MUE's

I have been reviewing hospital billing edits for labs billed that are not listed on the CMS MUE list. Some examples are 83894, 83896, 83898, 86235, 83914, 88185. Does anyone know of any resources on... [ Read More ]

Modifer 59

Labs were done 86235 Extractable nuclear antigen, antibody to, any method, each antibody. How would you file this? Would it be: 86235 86235 X 4- 59 or would you could it as follows: 86235 86235- ... [ Read More ]

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