How To Use CPT Code 86920

CPT 86920 describes the compatibility test between patient serum and a potential donor blood unit using an immediate spin technique. 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 86920?

CPT 86920 can be used to describe the compatibility test performed by a lab analyst to check the compatibility of a potential donor blood unit with patient serum. This test is conducted using an immediate spin technique, which involves mixing patient serum with red blood cells (RBCs) from the potential donor blood unit and observing for any agglutination or clumping reaction.

2. Official Description

The official description of CPT code 86920 is: ‘Compatibility test each unit; immediate spin technique.’

3. Procedure

1. The lab analyst mixes patient serum with RBCs from the potential donor blood unit.
2. The mixture is then spun in a centrifuge to observe for any agglutination or clumping reaction.
3. If agglutination occurs, the potential donor blood unit should not be transfused to the patient.

4. Qualifying circumstances

CPT 86920 is typically ordered by clinicians as the final step to ensure compatibility between patient blood and potential donor blood before proceeding with a transfusion. It is performed if the patient and donor unit match for ABO and Rh blood types and the patient has no significant antibodies. This test is not limited to a specific condition and can be used for any patient requiring a blood transfusion.

5. When to use CPT code 86920

CPT code 86920 should be used when performing a compatibility test between patient serum and a potential donor blood unit using the immediate spin technique. It is important to ensure that the patient and donor unit match for ABO and Rh blood types and that the patient has no significant antibodies. This code should be reported for each potential donor unit tested, regardless of whether it is transfused to the patient or not.

6. Documentation requirements

To support a claim for CPT 86920, the documentation should include:

• Confirmation of patient and donor unit matching for ABO and Rh blood types
• Results of the compatibility test, including any agglutination or clumping reaction observed
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86920, ensure that the compatibility test is performed using the immediate spin technique. It is important to report one unit of 86920 for each potential donor unit tested, regardless of whether it is transfused to the patient or not. Some payers may also separately reimburse for the collection of the specimen using a code such as 36415 for venipuncture.

8. Historical information

CPT 86920 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 compatibility test between patient serum and a potential donor blood unit using the immediate spin technique. No agglutination or clumping reaction is observed, indicating compatibility for transfusion.
2. Following separate testing for ABO and Rh blood types and RBC antibody screening, a compatibility test is performed between patient serum and a potential donor blood unit using the immediate spin technique. Agglutination is observed, indicating incompatibility for transfusion.
3. A patient requires a blood transfusion, and a compatibility test is performed between their serum and a potential donor blood unit using the immediate spin technique. No agglutination or clumping reaction is observed, ensuring compatibility for transfusion.
4. As part of a pre-transfusion protocol, a compatibility test is performed between patient serum and a potential donor blood unit using the immediate spin technique. Agglutination is observed, indicating incompatibility for transfusion.
5. A lab analyst conducts a compatibility test between patient serum and a potential donor blood unit using the immediate spin technique. No agglutination or clumping reaction is observed, confirming compatibility for transfusion.
6. Following the determination of ABO and Rh blood types and RBC antibody screening, a compatibility test is performed between patient serum and a potential donor blood unit using the immediate spin technique. Agglutination is observed, indicating incompatibility for transfusion.
7. A patient requires a blood transfusion, and a compatibility test is performed between their serum and a potential donor blood unit using the immediate spin technique. No agglutination or clumping reaction is observed, ensuring compatibility for transfusion.
8. As part of a pre-transfusion protocol, a compatibility test is conducted between patient serum and a potential donor blood unit using the immediate spin technique. Agglutination is observed, indicating incompatibility for transfusion.
9. A lab analyst performs a compatibility test between patient serum and a potential donor blood unit using the immediate spin technique. No agglutination or clumping reaction is observed, confirming compatibility for transfusion.
10. Following separate testing for ABO and Rh blood types and RBC antibody screening, a compatibility test is performed between patient serum and a potential donor blood unit using the immediate spin technique. Agglutination is observed, indicating incompatibility for transfusion.