CPT 86593
Global XXXSyphilis test non-trep quant
This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.
CPT 86593 Billing & Documentation Guide
CPT code 86593 (Syphilis test non-trep quant) is classified under Pathology/Lab with a global period indicator of XXX. This code uses the No national RVU payment methodology rather than standard RVU-based Physician Fee Schedule pricing. Refer to the methodology notice above for billing implications.
When billing 86593, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 86593 with related codes; this code has 5 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Statutory exclusion
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 86593 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
NCCI Bundling Edits, CPT 86593
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 86593 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 86592 | Column 1 (primary), can be billed with modifier | 9 | Sequential procedure |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0064U | Column 2 (secondary), bundled into primary | No | HCPCS/CPT procedure code definition |
| 0065U | Column 2 (secondary), bundled into primary | No | HCPCS/CPT procedure code definition |
| 0210U | Column 2 (secondary), bundled into primary | No | Mutually exclusive procedures |
Frequently Asked Questions, CPT 86593
What does CPT code 86593 mean? +
CPT code 86593 represents: Syphilis test non-trep quant. It's in the Pathology/Lab category with a global period of XXX.
What is the Medicare reimbursement for CPT 86593? +
This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.
What modifiers can I use with CPT 86593? +
Pathology and laboratory use modifier 90 (reference/outside lab), 91 (repeat clinical diagnostic test same day), 92 (alternative laboratory platform), and QW (CLIA waived test). Surgical pathology splits between 26 and TC where applicable.
What bundling edits apply to CPT 86593? +
This code has 5 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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