New QuantiFERON-TB Blood Test Benefit

The QuantiFERON-TB blood test is a new benefit reimbursable with CPT-4 code 86849 (unlisted immunology procedure) for only the following circumstances.

• Initial and serial testing of individuals with increased risk of latent tuberculosis infection (LTBI), such as recent foreign immigrants, injection-drug users, employees of correctional institutions and residents of homeless shelters
• Initial and serial testing for individuals who by history are at low risk for LTBI but whose future activity may place them at increased risk of exposure, such as healthcare workers and military personnel
• Individuals who require the test to meet entrance requirements for school and certain workplaces

Claim Completion

Claims submitted for QuantiFERON-TB blood tests must include the following in the Reserved For Local Use field (Box 19) or on an attachment to the claim.

• QuantiFERON-TB blood test
• Recipient age (must be 18 years of age or older)
• Medical justification

Providers also must submit with the claim:

• An invoice for the blood test

Refer to manual replacement pages path an over 6 (Part 2) and path immun 2 and 3 (Part 2).