CPT® Code 86787 is used to report laboratory testing for antibodies to the varicella-zoster virus (VZV), the virus responsible for chickenpox (varicella) and shingles (herpes zoster). This test helps determine whether a patient has evidence of prior infection, vaccination, or immunity to VZV.
This code represents the antibody test itself, not specimen collection or interpretation services, which may be reported separately when appropriate.
Key Facts About CPT® 86787
- Service type: Laboratory test (immunology/serology)
- Test: Varicella-zoster virus antibody testing
- Specimen type: Serum or plasma
- Test purpose: Assess immunity or prior exposure to VZV
- Provider type: Laboratories, physicians, and qualified healthcare professionals
Common clinical indications:
- Verification of immunity to chickenpox
- Pre-employment or healthcare worker screening
- Evaluation of vaccination status
- Prenatal immunity assessment
- Determination of susceptibility to varicella infection
When to Use CPT® 86787
CPT 86787 is appropriate when:
- Assessing immunity to varicella-zoster virus
- Determining whether a patient has had prior infection or vaccination
- Evaluating individuals with uncertain immunization histories
- Screening patients at risk for VZV exposure
Examples:
- Testing a healthcare worker for evidence of varicella immunity
- Verifying immunity before employment or school enrollment
- Assessing a pregnant patient's varicella immune status
- Evaluating an individual with no documented vaccination history
Documentation Requirements
To support CPT 86787 billing, documentation should include:
- Patient identifiers and date of service
- Clinical indication for testing
- Specimen type (serum or plasma)
- Test performed (varicella-zoster virus antibody)
- Test result and date reported
- Ordering provider information
Clear documentation supports medical necessity and accurate laboratory billing.
Reimbursement and Coding Considerations
- CPT 86787 is generally covered when medically necessary
- Diagnosis coding should support immunity assessment, exposure risk, or clinical indication
- Often used for occupational health, prenatal care, and immunization evaluations
- Specimen collection may be billed separately if allowed by payer policy
- Coverage may vary when performed solely for administrative or employment purposes
Always verify payer-specific laboratory billing requirements.
How OptiMantra Supports Immunity Testing
OptiMantra’s integrated EMR and practice management system streamlines documentation and billing for CPT 86787:
With OptiMantra, providers can:
- Order VZV antibody testing within the patient chart
- Track immunization and immunity records over time
- Link laboratory results to preventive care and clinical decision-making
- Maintain organized laboratory documentation that supports billing compliance and audit preparedness
- Integrate serology testing into a unified patient care workflow
By centralizing laboratory and preventive care workflows, OptiMantra helps practices improve efficiency, ensure compliance, and optimize reimbursement.
Try OptiMantra for free here!
Disclaimer: CPT® codes are maintained by the American Medical Association. This guide is for informational purposes only and does not replace official coding guidelines or payer policies.
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