Healthcare Insights

Top 10 immunology procedures

The Current Procedural Technology (CPT) subcategory Pathology and Laboratory – Immunology tracks immunological tests for many different medical conditions and purposes. According to the National Institutes of Health (NIH), certain substances or pathogens in the body are detected with immunological techniques. Detectable targets include viruses, hormones and the blood pigment hemoglobin.

The tests can generally be divided into rapid tests and laboratory tests.

Reviewing the immunology CPTs from the Definitive Healthcare ClaimsMx product, we break down the top codes from 2021 below.

10 immunology procedures with the most claims in 2021

RankCPT codeCPT code descriptionNumber of proceduresExplore dataset
186140C-reactive protein3,855,516Explore
286803Hepatitis C antibody2,088,275Explore
386706Hepatitis B surface antibody (HBSAB)1,053,646Explore
486780Antibody; treponema pallidum1,022,962Explore
586592Syphilis rest non-trep; qualitative899,283Explore
686580Skin test; tuberculosis, intradermal785,599Explore
786038Antinuclear antibodies (ANA)651,391Explore
886769SARS-COV2 COVID-19 antibody585,195Explore
986704Hepatitis B core antibody (HBCAB); total575,997Explore
1086334Immunofix e-phoresis serum526,426Explore

Fig. 1  Data is from the Definitive Healthcare ClaimsMx product for calendar year 2021. Claims data is sourced from multiple medical claims clearinghouses in the United States and is updated monthly. Data is accurate as of July 2022.

What are the most common immunology procedures?

The C-reactive protein (CRP) test, CPT 86140, ranks at the top of the list with more than 3.8 million procedures. According to the Mayo Clinic, the CRP test is used to: check for inflammation due to an infection, help diagnose a chronic inflammatory disease (such as rheumatoid arthritis or lupus), determine the risk of heart disease and evaluate the risk of a second heart attack.

Other high-volume immunology procedures are CPT codes 86803, with nearly 2.1 million claims in 2021, and 86706, with 1 million procedures. Both tests look for antibodies to hepatitis in the blood, but there’s a key difference between the codes: In 86803 tests, a positive reactive hepatitis C antibody test indicates that the patient currently has the virus in their blood. For the 86706 tests, a “positive” or “reactive” hepatitis B surface antibody (HBSAB) result indicates that a person is protected against the hepatitis B virus.

The fourth code on the list, and the last with more than 1 million procedures in 2021, is an antibody test for treponema pallidum, which causes syphilis. The test helps to distinguish between current and previous infection.

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