How To Use CPT Code 86999

CPT 86999 describes an unlisted transfusion medicine procedure that does not have a specific code. 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 86999?

CPT 86999 is used to report transfusion medicine procedures that do not have a specific code. It is used when there is no existing CPT code that accurately represents the service provided by the analyst performing the procedure. This code should only be used when there is no other appropriate code available.

2. Official Description

The official description of CPT code 86999 is: ‘Unlisted transfusion medicine procedure.’ There are no additional notes or guidelines provided for this code.

3. Procedure

1. The analyst performs a transfusion medicine procedure that is not represented by any of the standard and active CPT codes available.
2. The procedure may involve various aspects of transfusion medicine, such as blood typing, crossmatching, antibody identification, or other specialized tests or procedures.
3. Since there is no specific code available for the procedure performed, CPT code 86999 is used to report it.

4. Qualifying circumstances

CPT 86999 can be used when there is no other appropriate code available to accurately describe the transfusion medicine procedure performed. It is important to ensure that there is no specific code that closely approximates the service provided before reporting CPT 86999. The analyst must carefully evaluate the available codes and determine that none of them accurately represent the procedure performed.

5. When to use CPT code 86999

CPT code 86999 should only be used when there is no other specific code available to accurately describe the transfusion medicine procedure performed. It is important to thoroughly review the available codes and determine that none of them closely match the service provided. If there is a specific code that closely approximates the procedure, that code should be used instead of CPT 86999.

6. Documentation requirements

To support a claim for CPT 86999, it is essential to provide detailed documentation. The documentation should include a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. It should also include one or more similar codes and compare the service provided to those codes to justify the claim amount. Relevant documentation should be included to strengthen the claim and avoid possible denial. Payers will evaluate claims with unlisted procedure codes on a case-by-case basis and determine payment based on the documentation provided.

7. Billing guidelines

When billing for CPT 86999, it is important to follow specific guidelines. Ensure that there is no other appropriate code available to accurately describe the transfusion medicine procedure performed. If there is a specific code that closely approximates the service, that code should be used instead of CPT 86999. Include a cover letter explaining the reason for choosing the unlisted code and provide one or more similar codes for comparison. Submit relevant documentation to support the claim and avoid possible denial. Payers will evaluate claims with unlisted procedure codes on a case-by-case basis and determine payment based on the documentation provided.

8. Historical information

CPT 86999 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. An analyst performs a specialized transfusion medicine procedure to identify rare antibodies in a patient’s blood.
2. A transfusion medicine specialist performs a complex crossmatching procedure to ensure compatibility between a donor’s blood and a recipient’s blood.
3. An analyst performs a specialized transfusion medicine test to determine the blood type of a patient with a rare blood group.
4. A transfusion medicine technician performs a procedure to prepare platelet concentrates from a donor’s blood for transfusion.
5. An analyst performs a specialized transfusion medicine procedure to detect and identify antibodies in a patient’s blood that may cause adverse reactions during transfusion.
6. A transfusion medicine specialist performs a procedure to prepare cryoprecipitate from a donor’s blood for use in treating patients with certain bleeding disorders.
7. An analyst performs a specialized transfusion medicine test to determine the compatibility between a donor’s blood and a recipient’s blood for a specific transfusion procedure.
8. A transfusion medicine technician performs a procedure to prepare fresh frozen plasma from a donor’s blood for use in treating patients with coagulation disorders.
9. An analyst performs a specialized transfusion medicine procedure to perform a direct antiglobulin test on a patient’s blood to detect the presence of antibodies.
10. A transfusion medicine specialist performs a procedure to prepare leukocyte-reduced red blood cells from a donor’s blood for use in patients with a history of transfusion reactions.