{
    "code": "86235",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/86235/2014/B",
    "release_specific_url": "https://localishealth.com/cpt/86235/2015/A",
    "description": "A test for antibodies against a specific extractable nuclear antigen - the family that includes anti-Smith, anti-RNP, anti-SSA/Ro, anti-SSB/La, anti-Scl-70, and anti-Jo-1. Each individual antibody is a separate identifiable target, so a workup that checks several of them involves several tests. The pattern of which ones are present helps distinguish lupus from Sjogren syndrome, scleroderma, mixed connective tissue disease, and inflammatory myositis.",
    "answer": {
        "question": "Did Medicare pay separately for CPT 86235 in Q1 2015?",
        "text": "Not at a published national rate. CPT 86235 carries status X (statutory exclusion) in the Q1 2015 release. The statutory definition of physician services does not include this item. Treat the blank amount as unpriced, not as $0."
    },
    "release": {
        "schedule": "pfs",
        "year": 2015,
        "quarter": "A",
        "label": "Q1 2015",
        "effective": "January 1 – March 31, 2015",
        "revision": 1
    },
    "status": {
        "code": "X",
        "non_facility_payable": false,
        "facility_payable": false
    },
    "national_rates_usd": {
        "office_non_facility": null,
        "facility": null,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": null,
        "practice_expense_non_facility": null,
        "practice_expense_facility": null,
        "malpractice": null
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.7547,
    "source": {
        "label": "Physician relative value file (Q1 2015)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu15a.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2015/A",
        "file": "PPRRVU15_V1223c.csv",
        "row": 13732,
        "sha256": "d600c52a7d5f75737599c9a879cc0ffc8c85766bee82e9e2eadf49af364314d2"
    },
    "modified_at": "2026-08-04T03:05:39+00:00"
}