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    v1.0.30
    OpenPayerBilling CodesTransfusion Medicine ProceduresCPT cpt-86850-rbc-antibody-screening
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    CPT 86850: Screening Test for Non‑A/B Red Blood Cell Antibodies

    Commercial payers pay $22 on average nationally for this procedure.

    CPT code 86850 describes a laboratory screening test for unexpected antibodies to red blood cells (RBCs) using a patient’s blood specimen; this is a blood bank/serology service performed by a clinical laboratory or hospital blood bank to detect non‑A and non‑B RBC antibodies prior to transfusion or as part of immunohematology evaluation, typically provided in an outpatient laboratory, hospital lab, or transfusion service setting.

    For related coverage guidance, see recent payer policy updates: Hematology - Adzynma, Tumor Treating Fields for Pancreatic Cancer, Axicabtagene ciloleucel (Yescarta®) coverage.

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    National Reimbursement Benchmarks

    Commercial reimbursement for CPT 86850 centers on BUCA as the average commercial benchmark at $21.9, with payer-specific distributions showing meaningful variation. Blue Cross Blue Shield (BCBS) and Aetna demonstrate higher median and mean positions versus Cigna and UnitedHealth Group: BCBS mean is $30.7 with median $29.6, Aetna mean $11.3 with median $8, Cigna mean $10.2 median $8.7, and UnitedHealth Group mean $8.7 median $5.9. BUCA’s average sits between the higher BCBS cluster and the lower UnitedHealth Group/Cigna cluster, offering a mid-market reference at $21.9.

    Dispersion (P75 minus P25) highlights differences in rate concentration across payers: Blue Cross Blue Shield has a spread of $13.5 ($37.8 - $22.5), the widest among listed payers; Aetna’s spread is $7.4 ($13.4 - $6.0); Cigna’s spread is $7.9 ($12.9 - $5.0); UnitedHealth Group is the tightest with a spread of $5.8 ($9.9 - $4.1). These ranges indicate BCBS has the greatest variability while UnitedHealth Group shows the most compressed commercial rates around its central tendency.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 45-year-old patient presents to the outpatient phlebotomy lab after a hematology consultation for newly recognized anemia with indirect hyperbilirubinemia and a positive direct antiglobulin test. The clinician orders a screening test to detect unexpected red blood cell (RBC) antibodies other than the A and B blood group antigens to evaluate for immune-mediated hemolysis and to guide transfusion planning. A labeled blood specimen is collected in the clinical laboratory; the medical laboratory scientist performs 86850 using patient serum/plasma against reagent RBCs to screen for clinically significant allo- or autoantibodies. Results are documented in the laboratory information system and communicated to the ordering clinician and transfusion service when antibodies are detected or when pre-transfusion testing is required. Typical sites of service include the hospital clinical laboratory, outpatient hospital laboratory draw station, or an independent clinical medical laboratory. Typical clinical workflow steps: sample collection with correct patient identification, receipt and accessioning in the laboratory, performance of the antibody screen (86850), reflex confirmatory testing if positive, reporting of results, and incorporation of findings into transfusion compatibility planning when indicated.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    86900

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    90Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
    91Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    291U00000X
    207ZP0102X
    207Q00000X
    204C00000X
    367H00000X
    363AS0400X
    261QP3300X
    247200000X

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    D56.1Beta thalassemia
    D57.819Other sickle-cell disorders with crisis, unspecified
    D59.0Drug-induced autoimmune hemolytic anemia
    D59.1
    D59.9Acquired hemolytic anemia, unspecified
    D62Acute posthemorrhagic anemia
    D63.1Anemia in chronic kidney disease
    D64.9Anemia, unspecified
    D66Hereditary factor VIII deficiency
    D67Hereditary factor IX deficiency

    Showing 1–10 of 27

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    10 rows

    PolicyPayerEffective Date
    Hematology - AdzynmaCigna2026-10-15
    Tumor Treating Fields for Pancreatic Cancerselect_health2026-10-01
    Axicabtagene ciloleucel (Yescarta®) coverageBaylor Scott & White Health Plan2026-10-01
    Electric Tumor Treatment Field Therapy (for Kentucky Only)UnitedHealthcare2026-10-01
    Electric Tumor Treatment Field Therapy (for Kansas Only)UnitedHealthcare2026-10-01
    Electric Tumor Treatment Field Therapy (for Idaho Only)UnitedHealthcare2026-10-01
    Brexucabtagene autoleucel (Tecartus) CoverageBaylor Scott & White Health Plan2026-10-01
    Electric Tumor Treatment Field Therapy (for Pennsylvania Only)UnitedHealthcare2026-10-01
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Factor VIII ProductsCigna2026-09-15

    Related Codes

    CPT-86860-RBC-ELUTION-IMMUNOHEMATOLOGY-BLOOD-BANK

    CPT 86860: RBC Elution for Antibody Detection

    CPT-86870-RBC-ANTIBODY-IDENTIFICATION-IMMUNOHEMATOLOGY

    CPT 86870: Antibody Identification to Red Blood Cells

    CPT-86880-DIRECT-ANTIGLOBULIN-TEST-DAT-COOMBS

    CPT 86880: Direct Antihuman Globulin (Coombs) Test

    CPT-86885-INDIRECT-ANTIGLOBULIN-COOMBS-TEST

    CPT 86885: Indirect Antiglobulin (Coombs) Test for Serum Antibodies

    CPT-86886-INDIRECT-ANTIGLOBULIN-COOMBS-TEST-SERIAL-DILUTIONS

    CPT 86886: Indirect Antihuman Globulin (Coombs) Test

    CPT-86890-AUTOLOGOUS-BLOOD-COLLECTION-PROCESSING-STORAGE

    CPT 86890: Autologous Blood Collection, Processing, and Storage

    CPT-86891-INTRAOPERATIVE-BLOOD-SALVAGE-AUTOTRANSFUSION

    CPT 86891: Intraoperative Blood Salvage (Cell Salvage)

    CPT-86900-ABO-BLOOD-TYPING-SERUM-PLASMA

    CPT 86900: ABO Blood Typing Using Serum or Plasma

    CPT-86901-RH-BLOOD-GROUP-TYPING-SEROLOGIC-PLASMA-SERUM

    CPT 86901: Rh Blood Group Serologic Typing, Serum/Plasma

    CPT-86902-ANTIGEN-SCREENING-DONOR-BLOOD-UNIT

    CPT 86902: Antigen Screen of Donor Blood Unit

    Showing 1–10 of 38

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Blood typing, serologic
    Performed to determine ABO group; often ordered with 86850 when establishing patient ABO type prior to transfusion.
    86901Blood typing, serologicAlternate blood typing code; used when additional serologic typing is required alongside antibody screen.
    86923Compatibility test for each unitUsed during crossmatch and compatibility testing when the antibody screen (86850) is positive or when transfusion of specific donor units is planned.