How To Use CPT Code 86900

CPT 86900 is a code used for blood typing, specifically within the ABO blood group system. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 86900 procedures.

1. What is CPT 86900?

CPT 86900 is a code used in medical billing and coding to represent a specific laboratory procedure, which involves blood typing within the ABO blood group system. This test is essential for determining a patient’s blood type, which is crucial for various medical procedures, such as blood transfusions and organ transplants.

2. 86900 CPT code description

The official description of CPT code 86900 is: “Blood typing, serologic; ABO.”

3. Procedure

The procedure for CPT 86900 involves the following steps:

1. A blood sample is collected from the patient, typically through venipuncture.
2. The lab analyst performs a test to determine the patient’s blood type within the ABO blood group system using serum plasma as the specimen.
3. The lab method may include steps such as mixing the patient’s red blood cells (RBCs) with known antibodies to type A surface antigens and type B surface antigens and observing the mixture for an agglutination, or clumping, reaction.
4. Agglutination in the presence of a known antibody indicates the presence of the corresponding antigen on the surface of the patient’s RBCs.
5. The patient’s blood type is determined based on the agglutination reactions observed.

4. Qualifying circumstances

Patients who require blood typing for various medical reasons, such as blood transfusions, organ transplants, or other medical procedures, are eligible to receive CPT code 86900 services. Additionally, this test may be ordered for patients with certain medical conditions that require knowledge of their blood type for proper treatment and management.

5. When to use CPT code 86900

It is appropriate to bill the 86900 CPT code when a patient requires blood typing within the ABO blood group system for medical purposes, such as blood transfusions, organ transplants, or other medical procedures. This code may also be used for patients with specific medical conditions that necessitate knowledge of their blood type for proper treatment and management.

6. Documentation requirements

To support a claim for CPT 86900, the following information should be documented:

• Patient’s demographic information, including name, date of birth, and medical record number.
• Ordering physician’s name and contact information.
• Date and time of the blood sample collection.
• Specific details of the blood typing procedure, including the method used and the results of the agglutination reactions.
• Patient’s blood type as determined by the procedure.
• Any relevant clinical information or medical history that supports the need for blood typing.

7. Billing guidelines

When billing for CPT code 86900, it is essential to follow the appropriate guidelines and rules. Some payers may pay separately for collecting the specimen using a code such as 36415 for venipuncture. Additionally, ensure that all required documentation is complete and accurate to support the claim for CPT 86900 services.

8. Historical information

CPT 86900 was added to the Current Procedural Terminology system on January 1, 1993. The code was changed on January 1, 2015, with the previous descriptor being “Blood typing; ABO.”

9. Similar codes to CPT 86900

Five similar codes to CPT 86900 and how they differentiate are:

• CPT 86901: This code is used for blood typing within the Rh (D) blood group system, rather than the ABO system.
• CPT 86902: This code is used for blood typing of other blood group antigens, excluding ABO and Rh (D).
• CPT 86904: This code is used for blood typing of multiple blood group antigens, including ABO and Rh (D).
• CPT 86905: This code is used for blood typing of multiple blood group antigens, excluding ABO and Rh (D).
• CPT 86906: This code is used for blood typing of weak D (Du) antigens, which are a variant of the Rh (D) blood group system.

10. Examples

Here are 10 detailed examples of CPT code 86900 procedures:

1. A patient requires a blood transfusion due to severe anemia, and their blood type needs to be determined using CPT 86900.
2. A patient is scheduled for a kidney transplant, and their blood type must be confirmed using CPT 86900 to ensure compatibility with the donor organ.
3. A pregnant woman’s blood type needs to be determined using CPT 86900 to assess the risk of hemolytic disease of the newborn.
4. A patient with a history of multiple blood transfusions requires blood typing using CPT 86900 to ensure accurate records of their blood type.
5. A patient with a rare blood disorder requires blood typing using CPT 86900 for proper treatment and management of their condition.
6. A patient undergoing chemotherapy treatment requires blood typing using CPT 86900 to determine the appropriate blood products for transfusion support.
7. A patient with a history of autoimmune hemolytic anemia requires blood typing using CPT 86900 to guide treatment decisions.
8. A patient participating in a clinical trial for a new blood product requires blood typing using CPT 86900 as part of the study protocol.
9. A patient with a history of severe allergic reactions to blood transfusions requires blood typing using CPT 86900 to identify potential blood group incompatibilities.
10. A patient undergoing a stem cell transplant requires blood typing using CPT 86900 to ensure compatibility with the donor stem cells.