Summary & Overview
CPT 85244: Factor VIII Related Antigen, Serum
CPT code 85244 denotes a laboratory immunoassay performed to detect factor VIII related antigen in patient serum. This assay is clinically relevant for evaluating coagulation factor status and for diagnostic workups of bleeding or clotting disorders. As a billed laboratory service, it is routinely processed by major national payers and Medicare, with coverage and reimbursement subject to payer-specific laboratory policies and medical necessity requirements.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how CPT code 85244 is defined, typical clinical contexts for ordering the test, and common sites of service. The publication summarizes national benchmarks for utilization and reimbursement where available, highlights policy considerations affecting laboratory code adjudication, and explains coding and billing context relevant to hospital and independent clinical laboratories.
This summary provides a national perspective intended for policy analysts, laboratory billing staff, and clinical managers seeking concise information on the purpose and processing context for CPT code 85244.
Billing Code Overview
CPT code 85244 describes a laboratory assay in which a lab analyst tests a patient’s serum to determine the presence of factor VIII related antigen. This test evaluates circulating antigen levels associated with factor VIII, a blood coagulation protein relevant to bleeding disorders and thrombophilia assessments.
Service Type: Laboratory test — immunoassay/serology
Typical Site of Service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A 42-year-old male with a history of unexplained mucocutaneous bleeding is referred to hematology for evaluation of a possible von Willebrand disease or acquired von Willebrand syndrome. The hematologist orders a panel that includes an assay for factor VIII related antigen to evaluate circulating von Willebrand factor and assess factor VIII carrier protein levels. A phlebotomy technician draws blood in a sodium citrate tube; the sample is processed in the laboratory where an immunoassay or antigenic assay is performed by a clinical laboratory scientist using CPT 85244. Results are reviewed by the laboratory director and reported to the ordering provider. Typical sites of service include an outpatient hospital laboratory, independent clinical laboratory, or hospital inpatient laboratory when performed for an admitted patient.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing for the professional interpretation or report by a pathologist/clinical laboratory physician separate from the technical component. |
TC | Technical component |