Summary & Overview
CPT 85246: von Willebrand Factor (VWF) Antigen Measurement
CPT code 85246 represents a laboratory assay to measure von Willebrand factor (VWF) antigen in patient plasma, a diagnostic test used in the evaluation of bleeding disorders and coagulation abnormalities. Nationally, this code is relevant to hematology, coagulation testing, and laboratory service reimbursement given the clinical role of VWF antigen in diagnosing von Willebrand disease and assessing platelet function.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the test, typical sites of service, and payer coverage scope. The publication summarizes benchmark information for utilization and reimbursement patterns where available, highlights common billing and documentation considerations, and outlines related procedural coding connections to aid coding accuracy.
The content is intended for a national audience of laboratory managers, billing professionals, and clinical stakeholders seeking a clear reference on the clinical purpose and billing identity of CPT code 85246, with practical context for claims processing and clinical interpretation.
Billing Code Overview
CPT code 85246 describes a laboratory measurement of von Willebrand factor (VWF) antigen performed on patient plasma. This service involves a clinical laboratory analyst conducting an assay to quantify the amount of VWF antigen, a protein important for blood clotting and hemostasis.
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Service type: Clinical laboratory diagnostic test
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Typical site of service: Clinical laboratory or hospital laboratory setting
Clinical & Coding Specifications
Clinical Context
A 28-year-old female presents to the outpatient hematology clinic with a six-month history of easy bruising, frequent nosebleeds, and menorrhagia. The hematologist orders a panel of hemostasis studies, including a von Willebrand factor antigen measurement to quantify the amount of VWF protein in plasma. Blood is drawn in the outpatient laboratory; the phlebotomy specimen is processed to platelet-poor plasma and delivered to the clinical laboratory. A medical technologist or laboratory analyst performs 85246 to measure VWF antigen by immunoassay. Results are reported in international units or percent of normal and placed into the electronic medical record for the ordering provider. The result, in conjunction with VWF activity assays and factor VIII levels, informs diagnosis and management of von Willebrand disease or acquired VWF deficiency. Typical site of service: outpatient laboratory or hospital clinical laboratory. Service type: clinical laboratory diagnostic test performed on patient plasma.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the professional interpretation portion, if applicable for specialized reference lab testing |
59 |