CPT 86580: TB Skin Test (PPD/Mantoux)
Skin test; tuberculosis, intradermal (Mantoux test). Placement and reading of a tuberculin skin test for tuberculosis screening.
Why CPT 86580 Claims Get Denied
Claims billed under CPT 86580 are frequently denied or downcoded for the following reasons. Understanding these patterns helps your practice reduce denial rates and recover revenue faster.
Screening not medically necessary without risk factors
Duplicate with TB blood test (IGRA) on same date
Test placement and reading billed separately when should be one code
Not covered for routine employment screening by some payers
Billing Tips for CPT 86580
Bill once for placement and reading combined. Employment-related TB screening may not be covered by health insurance — it may be the employer's responsibility. Use Z11.1 for screening encounter diagnosis. Some payers prefer IGRA blood tests (86480) over skin tests.
Documentation Requirements
To support a clean claim for CPT 86580, your clinical documentation should include:
Clinical indication for TB screening
Test placement date and site
Reading date, induration measurement
Interpretation of results
Follow-up plan if positive
Reduce CPT 86580 Denials by 60%
RediClaim's pre-submission scrubber catches documentation gaps and coding errors before you submit, while the appeal generator handles denials that slip through.