Overview
CPT® Code 86308 is used to report a heterophile antibody screen, a blood test commonly used to detect antibodies associated with infectious mononucleosis (commonly caused by the Epstein-Barr virus). The test identifies heterophile antibodies produced in response to the infection, aiding in rapid diagnosis.
CPT 86308 represents the laboratory test itself. Interpretation, diagnosis, and patient counseling are billed separately.
Key Facts About CPT® 86308
- Service type: Clinical laboratory immunology test
- Provider type: Physicians, laboratories, and qualified healthcare professionals
- Medical services included: Screening for heterophile antibodies in blood
- Specimen type: Blood (serum)
- Common clinical indications:
- Diagnosis of suspected infectious mononucleosis
- Evaluation of fever, sore throat, and lymphadenopathy
- Differentiation from streptococcal pharyngitis or other viral infections
- Monitoring antibody response in atypical cases
When to Use CPT® 86308
CPT 86308 is appropriate when:
- A blood sample is collected to screen for heterophile antibodies
- The patient presents with symptoms suggestive of infectious mononucleosis
- Test results will influence diagnosis, patient management, or treatment decisions
Examples:
- Screening a teenager with fever, sore throat, and fatigue for infectious mononucleosis
- Differentiating viral pharyngitis from bacterial causes in an adult patient
- Evaluating lymphadenopathy with suspected EBV infection
Documentation Requirements
To properly support CPT 86308 billing, documentation should include:
- Patient identifiers and date of specimen collection
- Reason for testing and presenting symptoms
- Laboratory method used (if required by payer)
- Test results and interpretation
- Clinical follow-up or management based on findings
Complete documentation supports medical necessity, audit readiness, and continuity of care.
Reimbursement and Coding Considerations
- CPT 86308 is generally covered by Medicare, Medicaid, and commercial insurers when medically necessary
- Interpretation and management services are billed separately
- Payer-specific rules may apply for screening versus diagnostic use
- Frequency limits may be in place for repeat testing
- Always verify payer-specific policies for heterophile antibody testing
How OptiMantra Supports Infectious Disease Screening
OptiMantra’s integrated EMR and practice management system streamlines laboratory tracking, documentation, and billing for tests like CPT 86308.
With OptiMantra, providers can:
- Automatically link heterophile antibody orders to the patient chart
- Track results over time for longitudinal monitoring
- Document indications, symptoms, and follow-up plans in structured templates
- Generate audit-ready, compliant billing codes
- Integrate lab results into broader patient care plans
By centralizing lab tracking, documentation, and billing, OptiMantra ensures accuracy, compliance, and smooth workflows for infectious disease screening services.
Try OptiMantra for free here!
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