How To Use CPT Code 86901

CPT 86901 describes the procedure for blood typing within the Rh blood group system. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 86901?

CPT 86901 can be used to determine a patient’s blood type within the Rh blood group system. This code is specifically used for testing the presence of the RhD antigen on the surface of the patient’s red blood cells (RBCs). The test involves mixing the patient’s RBCs with known antibodies to the RhD antigen and observing for agglutination, or clumping, reaction. If agglutination occurs, it indicates the presence of the RhD antigen on the patient’s RBCs, indicating Rh positive blood. If no agglutination occurs, it indicates the absence of the RhD antigen, indicating Rh negative blood.

2. Official Description

The official description of CPT code 86901 is: ‘Blood typing, serologic; Rh (D).’ This code specifically refers to the serologic testing for the RhD antigen within the Rh blood group system.

3. Procedure

1. The lab analyst performs a test to determine the patient’s blood type within the Rh blood group system using serum plasma as the specimen.
2. The lab method may include steps such as mixing the patient’s RBCs with known antibodies to the RhD antigen and observing for agglutination reaction.
3. If agglutination occurs, it indicates the presence of the RhD antigen on the patient’s RBCs, indicating Rh positive blood. If no agglutination occurs, it indicates the absence of the RhD antigen, indicating Rh negative blood.

4. Qualifying circumstances

CPT 86901 is performed when there is a need to determine the patient’s blood type within the Rh blood group system. This test is commonly ordered as part of the initial blood typing process to find a compatible donor for a blood transfusion. It is also used as a screening test for pregnant women to determine if maternal immunization with antiRhD is necessary to prevent the formation of antibodies to fetal RBCs in cases where the fetus is Rh positive and the mother is Rh negative. This test is performed by a lab analyst using serum plasma as the specimen.

5. When to use CPT code 86901

CPT code 86901 should be used when there is a need to determine the patient’s blood type within the Rh blood group system. It is typically ordered in addition to ABO blood typing to provide a comprehensive blood type analysis. This code should be used when performing the serologic testing specifically for the RhD antigen. It is important to note that CPT code 86901 should not be reported if only ABO blood typing is performed without testing for the RhD antigen.

6. Documentation requirements

To support a claim for CPT code 86901, the following documentation is required:

• Indication of the need for blood typing within the Rh blood group system
• Details of the specific serologic testing method used, including the mixing of patient’s RBCs with known antibodies to the RhD antigen
• Results of the test indicating the presence or absence of the RhD antigen
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT code 86901, ensure that the test is performed to determine the patient’s blood type within the Rh blood group system. It should not be reported if only ABO blood typing is performed without testing for the RhD antigen. Additionally, some payers may separately reimburse for the collection of the specimen using a code such as 36415 for venipuncture.

8. Historical information

CPT code 86901 was added to the Current Procedural Terminology system on January 1, 1993. The code underwent a change on January 1, 2015, where the description was modified to specifically include the term ‘Rh (D)’ to indicate the testing for the RhD antigen within the Rh blood group system.

9. Examples

1. A lab analyst performs CPT code 86901 to determine the blood type of a patient within the Rh blood group system.
2. A physician orders CPT code 86901 as part of the initial blood typing process to find a compatible donor for a blood transfusion.
3. A pregnant woman undergoes CPT code 86901 to determine if maternal immunization with antiRhD is necessary to prevent the formation of antibodies to fetal RBCs.
4. A lab technician performs CPT code 86901 to screen for the presence of the RhD antigen in a patient’s blood.
5. A patient undergoes CPT code 86901 to confirm their Rh blood type before a surgical procedure.
6. A blood bank technician performs CPT code 86901 to determine the Rh blood type of a potential blood donor.
7. A physician orders CPT code 86901 to determine the Rh blood type of a patient with a history of blood transfusion reactions.
8. A lab analyst performs CPT code 86901 to determine the Rh blood type of a patient with a suspected Rh blood group system disorder.
9. A nurse collects a specimen for CPT code 86901 from a patient for blood typing within the Rh blood group system.
10. A lab technician performs CPT code 86901 to determine the Rh blood type of a patient before administering a Rh immune globulin injection.