How To Use CPT Code 86860
CPT 86860 describes the process of antibody elution, which involves the removal of bound antibodies from patient red blood cells (RBCs). This article will provide an overview of CPT code 86860, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.
1. What is CPT Code 86860?
CPT 86860 is used to describe the procedure of antibody elution, where lab analysts perform technical steps to remove antibodies bound to patient red blood cells (RBCs). This process may involve the use of solvents or physical methods to extract the bound antibodies, such as Glycine-HCl/EDTA, Chloroquine diphosphate, or heat elution.
2. Official Description
The official description of CPT code 86860 is: ‘Antibody elution (RBC), each elution.’
3. Procedure
- The lab analyst performs a procedure using patient red blood cells (RBCs) to remove bound antibodies in a process called RBC elution.
- The method may involve various solvents or physical processes, such as Glycine-HCl/EDTA, Chloroquine diphosphate, or heat elution, to help extract the bound antibodies.
4. Qualifying circumstances
CPT 86860 may be ordered by clinicians as a follow-up to a positive direct antihuman globulin test (DAT) to help diagnose autoimmune hemolytic anemia. This condition occurs when a patient has antibodies to their own RBCs, leading to the destruction of RBCs faster than they can be replaced. The antibody elution test helps evaluate the patient’s RBC antigen phenotype by removing interfering antibodies for testing and interpretation.
5. When to use CPT code 86860
CPT code 86860 should be used when performing the antibody elution procedure to remove bound antibodies from patient RBCs. It is important to note that this code represents each unique procedure, and if multiple antibody elution procedures are performed, each should be reported separately using CPT code 86860.
6. Documentation requirements
To support a claim for CPT 86860, documentation should include:
- Patient’s diagnosis and the need for antibody elution
- Specific method or solvent used for the elution procedure
- Date and details of the procedure
7. Billing guidelines
When billing for CPT 86860, ensure that the procedure is performed by a lab analyst. It is important to note that some payers may separately reimburse for specimen collection using a code such as 36415 for venipuncture. Additionally, if multiple antibody elution procedures are performed, each unique procedure should be reported using CPT code 86860.
8. Historical information
CPT 86860 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
- A lab analyst performing antibody elution to remove bound antibodies from patient RBCs for further testing and interpretation.
- Using solvents and physical processes, the lab analyst successfully elutes antibodies from patient RBCs to aid in the diagnosis of autoimmune hemolytic anemia.
- After a positive DAT, the lab analyst performs antibody elution to evaluate the patient’s RBC antigen phenotype.
- Multiple unique antibody elution procedures are performed by the lab analyst, and each is reported separately using CPT code 86860.
- Following a positive direct antihuman globulin test, the lab analyst performs antibody elution to remove interfering antibodies for accurate testing and interpretation.
