How To Use CPT Code 86870

CPT 86870 describes the process of identifying specific antibodies to red blood cells (RBCs) in patient 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 86870?

CPT 86870 can be used to identify specific antibodies to red blood cells (RBCs) in patient serum. This code is used when a lab analyst performs a test to determine the presence of antibodies in patient blood that may react with RBCs. The test involves mixing patient serum and/or plasma with a panel of type O RBCs that have known antigens, and evaluating the panel for agglutination, which indicates an antibody/antigen reaction. The lab analyst interprets the agglutination pattern to identify specific antibodies present in the patient’s blood.

2. Official Description

The official description of CPT code 86870 is: ‘Antibody identification, RBC antibodies, each panel for each serum technique.’

3. Procedure

1. The lab analyst collects a sample of patient serum or plasma.
2. The lab analyst mixes the patient sample with a panel of type O RBCs that have known antigens.
3. The lab analyst evaluates the panel for agglutination, which indicates an antibody/antigen reaction.
4. The lab analyst interprets the agglutination pattern to identify specific antibodies present in the patient’s blood.
5. The lab analyst may also use an indirect Coombs test, which involves incubating patient serum with reagent RBCs containing known RBC antigens and adding anti-human globulin to identify antibodies present in patient serum.

4. Qualifying circumstances

CPT 86870 is used when clinicians order a test to identify specific antibodies to RBCs in patient blood. This test may be ordered as a follow-up to a positive RBC antibody screen or to determine if a pregnant mother has specific antibodies that may attack fetal blood cells. It may also aid in the diagnosis of autoimmune hemolytic anemia, a condition in which the patient has antibodies to their own RBCs.

5. When to use CPT code 86870

CPT code 86870 should be used when a clinician orders a test to identify specific antibodies to RBCs in patient blood. It is appropriate to bill this code when the lab analyst performs the test using a panel of type O RBCs and evaluates the agglutination pattern to identify specific antibodies.

6. Documentation requirements

To support a claim for CPT 86870, the lab analyst must document the following information:

• Patient’s diagnosis or reason for ordering the test
• Details of the specific technique used for antibody identification
• Date of the test
• Results of the test, including the specific antibodies identified
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86870, ensure that the test is performed by a lab analyst using a panel of type O RBCs. This code should be reported for each unique procedure performed, which may include multiple RBC panels or different techniques. It is important to note that some payers may separately reimburse for specimen collection using a code such as 36415 for venipuncture.

8. Historical information

CPT 86870 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 lab analyst performs a test to identify specific antibodies to RBCs in patient serum, using a panel of type O RBCs and evaluating the agglutination pattern.
2. A clinician orders CPT 86870 to determine if a pregnant mother has specific antibodies that may attack fetal blood cells.
3. A patient with a positive RBC antibody screen undergoes CPT 86870 to identify the specific antibodies present in their blood.
4. A lab analyst performs an indirect Coombs test, incubating patient serum with reagent RBCs and adding anti-human globulin to identify antibodies present in patient serum.
5. A clinician orders CPT 86870 to aid in the diagnosis of autoimmune hemolytic anemia in a patient with suspected antibodies to their own RBCs.