How To Use CPT Code 86910

CPT 86910 describes the process of blood typing for paternity testing, specifically testing for the ABO, Rh, and MN antigen systems. This article will provide an overview of the code, 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 86910?

CPT 86910 is used to describe the blood typing procedure performed by a laboratory analyst to determine the likelihood of paternity. This test involves typing the blood of a single individual for antigens in the ABO, Rh, and MN blood group systems. The lab analyst uses various techniques, such as mixing the patient’s red blood cells with known antibodies and observing for agglutination, to establish the patient’s blood type.

2. Official Description

The official description of CPT code 86910 is: ‘Blood typing, for paternity testing, per individual; ABO, Rh and MN.’

3. Procedure

1. The lab analyst performs the technical steps to type a single individual’s red blood cells for antigens in the ABO, Rh, and MN blood group systems.
2. The lab method may include mixing the patient’s red blood cells with known antibodies and observing for agglutination.
3. The lab analyst interprets the results to establish the patient’s blood type in the ABO, Rh, and MN blood group systems.

4. Qualifying circumstances

CPT 86910 is typically performed in the context of paternity testing, although it is not limited to testing for specific conditions. The test is often conducted on a mother, child, and possible father to rule out paternity or establish the likelihood of paternity. It is important to note that this test does not prove paternity. Due to the legal implications of the test, establishing a legal chain of custody for the specimen is crucial. The test is usually performed with all parties present and their identities firmly established.

5. When to use CPT code 86910

CPT code 86910 should be used when performing blood typing for paternity testing, specifically testing for the ABO, Rh, and MN antigen systems. It is important to note that most insurance does not cover this test as it is not medically necessary for the diagnosis and treatment of disease. The use of this code may decrease as newer DNA test methods become more common.

6. Documentation requirements

To support a claim for CPT 86910, the following documentation is required:

• Patient’s blood type in the ABO, Rh, and MN blood group systems
• Explanation of the purpose of the test, such as paternity testing
• Establishment of legal chain of custody for the specimen

7. Billing guidelines

When billing for CPT 86910, it is important to note that most insurance does not cover this test. Some payers may separately reimburse for specimen collection using a code such as 36415 for venipuncture. It is crucial to follow the specific billing guidelines provided by the payer to ensure accurate reimbursement.

8. Historical information

CPT 86910 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 blood typing for paternity testing on a mother, child, and possible father to establish the likelihood of paternity.
2. Using CPT code 86910, the lab analyst types the blood of an individual to determine their ABO, Rh, and MN blood group systems for paternity testing purposes.
3. In a paternity testing scenario, the lab analyst performs blood typing on a single individual to establish their blood type in the ABO, Rh, and MN antigen systems using CPT code 86910.
4. For legal purposes, a lab analyst performs blood typing on a patient to determine their blood type in the ABO, Rh, and MN blood group systems using CPT code 86910.
5. Using CPT code 86910, the lab analyst performs blood typing on an individual to establish their blood type in the ABO, Rh, and MN antigen systems for paternity testing purposes.
6. In a paternity testing case, the lab analyst types the blood of a single individual to determine their ABO, Rh, and MN blood group systems using CPT code 86910.
7. A lab analyst performs blood typing on a patient to establish their blood type in the ABO, Rh, and MN antigen systems for paternity testing purposes, utilizing CPT code 86910.
8. Using CPT code 86910, the lab analyst types the blood of an individual to determine their ABO, Rh, and MN blood group systems in a paternity testing scenario.
9. In a paternity testing situation, the lab analyst performs blood typing on a single individual to establish their blood type in the ABO, Rh, and MN antigen systems using CPT code 86910.
10. For paternity testing purposes, a lab analyst performs blood typing on a patient to determine their blood type in the ABO, Rh, and MN blood group systems using CPT code 86910.