How To Use CPT Code 86905

CPT 86905 describes the identification of a specific red blood cell (RBC) antigen, other than ABO or RhD, using serologic blood typing. 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 86905?

CPT 86905 can be used to identify a specific RBC antigen, other than ABO or RhD, through serologic blood typing. This code is used when the lab analyst performs a test to determine the presence of a particular antigen on the surface of the patient’s RBCs. The test uses serum as the specimen and is performed to assess the patient’s blood type under antigen groups other than ABO and RhD.

2. Official Description

The official description of CPT code 86905 is: ‘Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each.’

3. Procedure

1. The lab analyst performs a test to identify a specific RBC antigen, other than ABO or RhD, present on the surface of the patient’s RBCs.
2. The lab method may include steps such as mixing patient RBCs with a known antibody to an antigen from a specific antigen group.
3. If agglutination, or clumping, occurs in the presence of a known antibody, it indicates the presence of the corresponding antigen on the patient’s RBCs.

4. Qualifying circumstances

CPT 86905 is used when there is a need to identify a specific RBC antigen, other than ABO or RhD, that may increase the likelihood of a transfusion reaction or hemolysis in a fetus or newborn. Clinicians may order this test to determine a patient’s blood type under antigen groups other than ABO and RhD. The test is performed by a lab analyst using various methods specific to each antigen group.

5. When to use CPT code 86905

CPT code 86905 should be used when there is a clinical need to identify a specific RBC antigen, other than ABO or RhD, in the patient’s blood. It is appropriate to bill this code when the lab analyst performs the serologic blood typing test to determine the presence of the antigen. This code should be reported for each specific RBC antigen identified.

6. Documentation requirements

To support a claim for CPT 86905, the documentation should include:

• Reason for ordering the test and the clinical need to identify the specific RBC antigen
• Details of the serologic blood typing test performed
• Results of the test indicating the presence or absence of the specific RBC antigen
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86905, ensure that the test is performed to identify a specific RBC antigen, other than ABO or RhD. It is important to report multiple units of CPT 86905 if the lab tests for multiple RBC antigens other than ABO and RhD. Additionally, some payers may separately reimburse for the collection of the specimen using a code such as 36415 for venipuncture.

8. Historical information

CPT 86905 was added to the Current Procedural Terminology system on January 1, 1993. It underwent a code change on January 1, 2015, with the updated description reflecting the identification of RBC antigens, other than ABO or RhD.

9. Examples

1. A lab analyst performs a serologic blood typing test to identify the presence of the Kell antigen on a patient’s RBCs.
2. During a blood transfusion, the lab analyst tests the patient’s blood to determine if there are any antibodies to antigens other than ABO or RhD.
3. A pregnant woman undergoes serologic blood typing to assess the risk of hemolytic disease of the newborn due to antigens other than ABO or RhD.
4. A patient with a history of transfusion reactions requires serologic blood typing to identify any potential antibodies to specific RBC antigens.
5. A lab analyst performs a serologic blood typing test to determine the presence of the Duffy antigen on a patient’s RBCs.
6. As part of preoperative testing, the lab analyst performs serologic blood typing to identify any potential antibodies to RBC antigens other than ABO or RhD.
7. A newborn undergoes serologic blood typing to determine the presence of specific RBC antigens that may cause hemolysis.
8. A patient with a suspected transfusion reaction requires serologic blood typing to identify any antibodies to specific RBC antigens.
9. A lab analyst performs a serologic blood typing test to determine the presence of the Kidd antigen on a patient’s RBCs.
10. During prenatal care, the lab analyst performs serologic blood typing to assess the risk of hemolytic disease of the newborn due to antigens other than ABO or RhD.