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

Rank CPT code CPT code description Number of procedures
1 86140 C-reactive protein 3,855,516
2 86803 Hepatitis C antibody 2,088,275
3 86706 Hepatitis B surface antibody (HBSAB) 1,053,646
4 86780 Antibody; treponema pallidum 1,022,962
5 86592 Syphilis rest non-trep; qualitative 899,283
6 86580 Skin test; tuberculosis, intradermal 785,599
7 86038 Antinuclear antibodies (ANA) 651,391
8 86769 SARS-COV2 COVID-19 antibody 585,195
9 86704 Hepatitis B core antibody (HBCAB); total 575,997
10 86334 Immunofix e-phoresis serum 526,426

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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