Overview
CPT® Code 86800 is used to report the measurement of thyroglobulin antibodies (TgAb) in serum or plasma. This laboratory test helps clinicians evaluate autoimmune thyroid disorders, such as Hashimoto’s thyroiditis or Graves’ disease, monitor therapy, and guide clinical decisions related to thyroid health.
This code represents the lab analysis itself. Interpretation, counseling, or clinical recommendations are billed separately.
Key Facts About CPT® 86800
- Service type: Clinical laboratory test
- Provider type: Physicians, laboratories, or qualified healthcare professionals
- Medical services included: Yes—quantitative measurement of thyroglobulin antibodies
- Specimen type: Serum or plasma
- Common clinical indications:
- Suspected or confirmed autoimmune thyroid disease
- Monitoring thyroid antibody levels during therapy
- Assessment of thyroid dysfunction (hyperthyroidism or hypothyroidism)
- Supporting diagnosis in thyroid cancer surveillance
When to Use CPT® 86800
CPT 86800 is appropriate when:
- A serum or plasma sample is collected for thyroglobulin antibody testing
- The test is medically necessary to evaluate or monitor autoimmune thyroid conditions
- Results will guide treatment, monitoring, or follow-up care
Example:
- Measuring TgAb levels in a patient with suspected Hashimoto’s thyroiditis to confirm autoimmune etiology
Documentation Requirements
To properly support CPT 86800 billing, documentation should include:
- Patient identifiers and date of specimen collection
- Sample type (serum or plasma)
- Medical indication for the test
- Laboratory method used (e.g., immunoassay)
- Test results and any follow-up recommendations
Accurate documentation ensures proper reimbursement, compliance, and integration into the patient’s longitudinal health record.
Reimbursement and Coding Considerations
- CPT 86800 is typically covered by commercial insurers, Medicare, and Medicaid when medically necessary
- Interpretation and counseling are billed separately
- Modifier use may be required if multiple tests are performed on the same specimen
- Always confirm payer-specific lab policies and bundling rules
How OptiMantra Supports Thyroglobulin Antibody Testing
OptiMantra’s integrated EMR and practice management system streamlines laboratory workflows for CPT 86800:
With OptiMantra, providers can:
- Automatically link TgAb orders to the patient’s chart for longitudinal tracking
- Monitor thyroid antibody trends over time for informed clinical decisions
- Document indications, methodology, and follow-up plans directly in the EMR
- Generate audit-ready, compliant billing codes for smooth claims processing
- Integrate lab results with the patient’s broader care plan for thyroid or endocrine management
By centralizing lab documentation, tracking, and billing, OptiMantra ensures accurate records, efficient workflows, and proper reimbursement for thyroid antibody testing.
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