Summary & Overview
CPT 86901: Blood Typing, Serologic (Rh) Procedure
CPT code 86901 is a widely used billing code for blood typing, specifically serologic testing for Rh factor. This procedure is a cornerstone in transfusion medicine, ensuring compatibility between donor and recipient blood types and preventing adverse reactions. The code is recognized nationally and is covered by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.
This publication provides a comprehensive overview of 86901, detailing its clinical significance, typical laboratory settings, and its role in pathology and laboratory procedures. Readers will gain insights into payer coverage, relevant benchmarks, and recent policy updates affecting reimbursement and utilization. The analysis also highlights associated modifiers and taxonomies, as well as common ICD-10 diagnoses linked to Rh blood typing.
Healthcare professionals, laboratory managers, and policy analysts will find this summary useful for understanding the national landscape of blood typing services, including payer trends and clinical context. The information is organized to support decision-making and awareness of current standards in transfusion medicine.
CPT Code Overview
CPT code 86901 represents blood typing; serologic (e.g., Rh). This procedure is classified under Pathology and Laboratory Procedures, specifically within Transfusion Medicine Procedures. It is typically performed in a laboratory setting such as Place of Service 19 or 81. The test is essential for determining a patient's Rh blood group, which is critical for safe transfusion practices and clinical decision-making.
Clinical & Coding Specifications
Clinical Context
A patient presents to a healthcare facility requiring blood transfusion or preoperative assessment. As part of the transfusion medicine workflow, a blood sample is collected and sent to the laboratory. The laboratory performs serologic blood typing to determine the patient's Rh status using procedure 86901 – Blood typing; serologic (e.g., Rh). This information is critical for ensuring compatibility with donor blood and preventing transfusion reactions. The procedure is typically performed in a laboratory setting (Place of Service 19 or 81) by a specialist or technologist in pathology.
Coding Specifications
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Modifiers:
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26: Professional Component. Used when only the interpretation of the blood typing test is performed by the physician or pathologist. - Modifier
TC: Technical Component. Used when only the technical aspect (e.g., specimen processing, test performance) is provided by the laboratory.
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Provider Taxonomies:
Taxonomy Code Specialty Name