How To Use CPT Code 86021

CPT 86021 describes the laboratory test used to detect and identify leukocyte antibodies in a patient’s blood sample. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 86021?

CPT 86021 is a code used to describe a laboratory test that detects and identifies leukocyte antibodies in a patient’s blood sample. Leukocyte antibodies are proteins produced by the body’s immune system in response to specific invaders or substances. This test is commonly performed in fertility clinics to assess the presence of leukocyte antibodies in individuals experiencing infertility. It can also be ordered for transfusion patients who have had a reaction to a blood transfusion.

2. Official Description

The official description of CPT code 86021 is: ‘Antibody identification; leukocyte antibodies.’

3. Procedure

1. The lab analyst receives a blood sample from the patient.
2. The lab analyst performs a series of technical steps to detect and identify leukocyte antibodies in the blood sample.
3. The analysis may involve using immunoassay techniques, such as flow cytometry, to assess the presence and quantity of leukocyte antibodies.
4. The lab analyst calculates the percentage of leukocyte antibodies by assessing the number of beads involved in an antigen-antibody reaction.
5. A normal level of leukocyte antibodies is typically around 50 percent, while levels below 30 percent may indicate increased risk of infertility.

4. Qualifying circumstances

CPT 86021 is typically ordered when there is a suspicion that leukocyte antibodies may be causing infertility in a patient. It may also be ordered for transfusion patients who have experienced a reaction to a blood transfusion. The test is performed by a lab analyst who specializes in detecting and identifying leukocyte antibodies in blood samples.

5. When to use CPT code 86021

CPT code 86021 should be used when a healthcare provider orders a laboratory test to detect and identify leukocyte antibodies in a patient’s blood sample. It is appropriate to use this code when there is a suspicion of leukocyte antibody-related infertility or when a transfusion patient has had a reaction to a blood transfusion.

6. Documentation requirements

To support a claim for CPT code 86021, the healthcare provider must document the following information:

• Reason for ordering the test, such as suspicion of leukocyte antibody-related infertility or transfusion reaction
• Date the blood sample was collected
• Results of the laboratory test, including the percentage of leukocyte antibodies detected
• Signature of the healthcare provider ordering the test

7. Billing guidelines

When billing for CPT code 86021, ensure that the laboratory test is performed to detect and identify leukocyte antibodies in a patient’s blood sample. It is important to follow the specific guidelines provided by the payer regarding documentation and coding requirements. Some payers may also separately reimburse for the collection of the blood sample using a different code, such as 36415 for venous blood collection.

8. Historical information

CPT code 86021 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A fertility clinic orders CPT code 86021 to detect and identify leukocyte antibodies in a blood sample from a patient experiencing infertility.
2. A patient who had a reaction to a blood transfusion undergoes CPT code 86021 to assess the presence of leukocyte antibodies in their blood sample.
3. A healthcare provider suspects leukocyte antibody-related infertility in a patient and orders CPT code 86021 to confirm the presence of leukocyte antibodies.
4. A laboratory receives a blood sample from a patient with suspected leukocyte antibody-related infertility and performs CPT code 86021 to detect and identify leukocyte antibodies.
5. A patient with a history of transfusion reactions undergoes CPT code 86021 to assess the presence of leukocyte antibodies in their blood sample before a future transfusion.