Blood test that measures antibodies directed against thyroglobulin, a protein made by the thyroid gland, often used in autoimmune thyroid workups.
- Medicare
- $0.00
- Work RVU
- 0
- Global, days
- Region
- General
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Thyroid symptoms or known thyroid history
- Prior thyroid labs such as TSH and free T4
- Musculoskeletal findings that raised the thyroid question
- Diagnosis code for the suspected thyroid condition
- Who will follow up on abnormal results
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
86800 reports a thyroglobulin antibody test. It is a thyroid lab, most often ordered by primary care or endocrinology to look at autoimmune thyroid disease or to interpret a thyroglobulin level in thyroid cancer follow-up.
It shows up around orthopedic care in a few ways. Hypothyroid patients have higher rates of carpal tunnel syndrome, frozen shoulder, and muscle aches, and a hand or shoulder clinic may see an outside lab panel that includes it. It also appears in pre-operative records. In most cases the ortho practice does not order it, and a TSH is the usual first test if thyroid disease is a concern.
The performing lab bills 86800 under the Clinical Laboratory Fee Schedule. If your practice ever orders it, link it to a thyroid diagnosis rather than the musculoskeletal complaint. A carpal tunnel diagnosis by itself will not carry a thyroid antibody test past most payers' edits.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 0 |
| Practice expense RVU | 0 |
| Malpractice RVU | 0 |
| Total RVU | 0 |
| Medicare national rate | $0.00 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $0.00 |
Common denial reasons
The recurring reasons claims for CPT 86800 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Linked to a musculoskeletal diagnosis with no thyroid indication
- No thyroid symptom, history, or abnormal lab documented
- Billed by the ordering office instead of the lab
- Frequency exceeds payer limits for monitoring
- Repeat test on the same day without modifier 91
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Can an orthopedic surgeon order a thyroglobulin antibody test?
02Is CPT 86800 the same as a thyroglobulin level?
03Does carpal tunnel syndrome justify thyroid antibody testing?
Sources & references
Editorial content was developed using the following public sources.
- 01CMS Physician Fee Schedule 2026
- 02CMS Clinical Laboratory Fee Schedule 2026
- 03cms.govhttps://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits
Mira Scribe
Mira Scribe pulls the thyroid history and related symptoms the patient mentions into the note, so any lab ordered from that discussion has a matching reason on record.
See how Mira captures CPT 86800 documentation