Overview
CPT® code 86141 is used to report a high-sensitivity C-reactive protein (hs-CRP) test, which measures very low levels of C-reactive protein in the blood. CRP is a protein produced by the liver in response to inflammation, and the high-sensitivity version of this test is specifically designed to detect subtle increases that may indicate cardiovascular risk or low-grade inflammation. Unlike standard CRP tests used for acute infections or inflammatory conditions, the hs-CRP test provides a more precise measurement suitable for preventive and risk-assessment purposes.
When to Use CPT 86141
Use CPT 86141 when performing a high-sensitivity CRP test to evaluate a patient’s cardiovascular risk profile or detect low-level systemic inflammation. This test is commonly ordered in the following situations:
- Assessing the risk of future cardiovascular events such as heart attack or stroke.
- Evaluating low-grade inflammation associated with metabolic syndrome or insulin resistance.
- Monitoring response to lifestyle or therapeutic interventions aimed at reducing cardiovascular risk.
- Differentiating between inflammatory and non-inflammatory causes of symptoms when standard CRP is normal.
Key Requirements
- The test must use a high-sensitivity assay specifically designed to detect low CRP concentrations (typically between 0.5–10 mg/L).
- Documentation should include the clinical rationale for ordering the test—such as cardiovascular risk assessment or inflammation monitoring.
- A serum or plasma specimen is required for accurate testing.
- Report CPT 86141 only for high-sensitivity CRP tests; use 86140 for standard CRP assays that detect higher levels of inflammation.
Billing Guidelines
- Report 86141 once per patient encounter unless separate, medically necessary testing is performed.
- Ensure documentation supports medical necessity—particularly if used for preventive screening rather than disease management.
- Do not report 86141 in conjunction with 86140 for the same specimen.
- When ordered as part of a cardiovascular risk panel, follow payer-specific coding and bundling rules.
Example Clinical Scenarios
- A provider orders hs-CRP testing for a patient with borderline cholesterol to assess inflammation-related cardiovascular risk.
- A physician monitors changes in hs-CRP after lifestyle interventions or statin therapy.
- A clinician evaluates low-grade inflammation in a patient with metabolic syndrome or unexplained fatigue.
Summary
CPT® code 86141 identifies laboratory testing for high-sensitivity C-reactive protein, a critical biomarker for cardiovascular and systemic inflammation risk assessment. It enables clinicians to detect subtle inflammatory changes that standard CRP testing might miss, helping guide prevention and long-term care decisions.
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