How To Use CPT Code 86156

CPT 86156 describes the screening of cold agglutinins, which are antibodies that cause blood to clump, by performing a technical lab test on a specimen such as serum. 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 86156?

CPT 86156 can be used to describe the screening of cold agglutinins, which are antibodies that cause blood to clump, by performing a technical lab test on a specimen such as serum. This code is used when a lab analyst measures serial dilutions of serum, saline, and type O donor blood cells into test tubes, refrigerates them, and observes for agglutination of the cells. The presence of cold agglutinins, typically IgM immunoglobulins, indicates the occurrence of clinical conditions such as mycoplasma pneumonia and hemolytic anemia.

2. Official Description

The official description of CPT code 86156 is: ‘Cold agglutinin; screen.’

3. Procedure

1. The lab analyst measures serial dilutions of serum, saline, and type O donor blood cells into test tubes.
2. The test tubes are refrigerated for several hours.
3. The analyst gently shakes the tubes and observes for agglutination of the cells.
4. Dispersal of the agglutinins after warming indicates the presence of cold agglutinins.
5. The results show as negative or positive for the screening test.

4. Qualifying circumstances

CPT 86156 is used when a clinician orders a cold agglutinin screen for patients experiencing symptoms such as pneumonia, shortness of breath, or unusual numbness in the extremities when exposed to cold air. The presence of cold agglutinins, typically IgM immunoglobulins, can be associated with clinical conditions including mycoplasma pneumonia and hemolytic anemia.

5. When to use CPT code 86156

CPT code 86156 should be used when a clinician orders a cold agglutinin screen to determine the presence of cold agglutinins in a patient’s serum. This code is appropriate when the lab analyst performs the technical lab test to screen the specimen for cold agglutinins. It should not be used for titer, which requires a different code (86157).

6. Documentation requirements

To support a claim for CPT 86156, the documentation should include:

• Reason for ordering the cold agglutinin screen
• Details of the technical lab test performed, including the measurement of serial dilutions and observation of agglutination
• Results of the screening test, indicating whether it was negative or positive

7. Billing guidelines

When billing for CPT 86156, ensure that the cold agglutinin screen is performed by a lab analyst. It is important to follow the specific guidelines for reporting this code and not to report it with other codes unless necessary. Consider the location of the testing, as it may affect how the code is reported.

8. Historical information

CPT 86156 was added to the Current Procedural Terminology system on January 1, 1993. There have been no updates to the code since its addition.

9. Examples

1. A clinician orders a cold agglutinin screen for a patient presenting with pneumonia symptoms.
2. A patient complains of shortness of breath and is referred for a cold agglutinin screen.
3. A patient experiences unusual numbness in the extremities when exposed to cold air, prompting a clinician to order a cold agglutinin screen.
4. A clinician suspects the presence of cold agglutinins in a patient with mycoplasma pneumonia and orders a cold agglutinin screen.
5. A patient with hemolytic anemia undergoes a cold agglutinin screen to assess the presence of cold agglutinins.
6. A clinician orders a cold agglutinin screen for a patient with unexplained symptoms related to exposure to cold air.
7. A patient with pneumonia symptoms undergoes a cold agglutinin screen to determine the presence of cold agglutinins.
8. A clinician orders a cold agglutinin screen for a patient with recurring shortness of breath.
9. A patient with unusual numbness in the extremities when exposed to cold air is referred for a cold agglutinin screen.
10. A clinician suspects the presence of cold agglutinins in a patient with hemolytic anemia and orders a cold agglutinin screen.