How To Use CPT Code 86886

CPT 86886 describes the indirect antihuman globulin test, also known as the Coombs test, which is performed by a lab analyst to detect antibodies 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 86886?

CPT 86886 can be used to describe the indirect antihuman globulin test, also known as the Coombs test. This test is performed by a lab analyst to detect antibodies in patient serum. It involves using serial dilutions of patient serum against test red blood cells (RBCs) with known antibodies and immunoglobulin class. The test helps evaluate the level of antibody present in patient blood.

2. Official Description

The official description of CPT code 86886 is: ‘Antihuman globulin test (Coombs test); indirect, each antibody titer.’

3. Procedure

1. The lab analyst performs the indirect antihuman globulin test using serial dilutions of patient serum against test RBCs with known antibodies and immunoglobulin class.
2. The lab analyst incubates the serial dilutions of patient serum with reagent RBCs containing known antigens, which will bind to the serum antibodies if present.
3. The lab analyst washes the RBC serum mixture, adds antihuman globulin (Coombs reagent), and monitors the mixture for agglutination (clumping of RBCs).
4. If agglutination occurs, it indicates the presence of antibodies in the patient serum.
5. The lab analyst compares the reactivity at several dilutions against an earlier specimen or a standard to evaluate the level of antibody present in patient blood.
6. Each test involving dilutions testing for a specific antibody or group of antibodies represents one unit of CPT 86886.

4. Qualifying circumstances

CPT 86886 is typically ordered by clinicians to evaluate the level of antibody present in patient blood. It can be used to assess antibodies formed by pregnant mothers against fetal blood, such as anti RhD, and to direct therapeutic treatment and predict outcomes. The test is not limited to specific conditions and can be used in various clinical scenarios.

5. When to use CPT code 86886

CPT code 86886 should be used when performing the indirect antihuman globulin test to detect antibodies in patient serum. It is important to note that this code is specifically for the titer test and should not be used for other types of Coombs tests, such as RBC antibody screening or identification using reagent red cell panels.

6. Documentation requirements

To support a claim for CPT 86886, the following documentation is required:

• Patient’s diagnosis or reason for ordering the test
• Details of the specific antibodies or group of antibodies being tested
• Date of the test
• Results of the test, including the level of antibody present in patient blood
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86886, ensure that the test is performed by a lab analyst and that the documentation requirements are met. It is important to note that CPT 86886 should not be reported with other codes for RBC antibody screening or identification. Additionally, if specimen collection is performed separately, a separate code for venipuncture may be reported.

8. Historical information

CPT 86886 was added to the Current Procedural Terminology system on January 1, 1993. There have been historical changes to the code, including a code change on January 1, 2008, which modified the description to ‘Antihuman globulin test (Coombs test); indirect, titer, each antiserum.’

9. Examples

1. A lab analyst performing an indirect antihuman globulin test to detect antibodies in patient serum for a specific antibody.
2. An obstetrician ordering the Coombs test to evaluate the level of anti RhD antibodies in a pregnant mother’s blood.
3. A hematologist using CPT 86886 to assess the presence of antibodies in a patient with a suspected autoimmune hemolytic anemia.
4. A transfusion medicine specialist performing the Coombs test to determine the compatibility of donor blood with a recipient’s blood.
5. A pediatrician ordering the test to evaluate the level of antibodies in a newborn with suspected hemolytic disease of the newborn.
6. A rheumatologist using CPT 86886 to assess the presence of antibodies in a patient with suspected autoimmune disorders.
7. An immunologist performing the Coombs test to evaluate the level of antibodies in a patient with a suspected immunodeficiency.
8. A gastroenterologist ordering the test to assess the presence of antibodies in a patient with suspected autoimmune liver disease.
9. A nephrologist using CPT 86886 to evaluate the level of antibodies in a patient with suspected antibody-mediated kidney diseases.
10. A hematopathologist performing the Coombs test to assess the presence of antibodies in a patient with suspected drug-induced immune hemolytic anemia.