Summary & Overview
CPT 86870: RBC Antibody Identification, Immunohematology
CPT code 86870 represents an immunohematology laboratory procedure to identify specific antibodies directed against red blood cells in patient serum. This test is clinically important for transfusion safety, evaluation of hemolytic anemia, and peripartum antibody screening; it informs compatibility testing and clinical management decisions. Nationally, accurate coding and reporting of this laboratory service affect billing, quality measurement, and laboratory workflow.
Key payers typically involved in coverage and reimbursement discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of CPT code 86870, common sites where the service is performed, and which payers are relevant for coverage considerations. The publication outlines benchmarks and reporting practices when available, summarizes policy implications for laboratory operations, and provides clinical context linking the assay to transfusion and hematology care pathways.
Data not available in the input for specific CPT-to-ICD-10 mappings, payer-specific fee schedules, and taxonomies. The content focuses on the code definition, clinical relevance, and the payer landscape at a national level.
Billing Code Overview
CPT code 86870 describes a laboratory test performed by a lab analyst to identify specific antibodies to red blood cells (RBCs) in patient serum. This assay detects and characterizes antibodies that may cause hemolytic reactions, transfusion incompatibility, or immune-mediated anemia.
Service Type: Immunohematology / Serologic Antibody Identification
Typical Site of Service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A 28-year-old pregnant woman presents to the outpatient laboratory after a prenatal visit. Her obstetrician ordered an antibody screen because she is blood type O negative and the initial prenatal screen suggested possible red blood cell (RBC) alloantibodies. A blood specimen is collected, labeled, and transported to the hospital reference laboratory. The lab analyst performs 86870 to identify specific antibodies in the patient’s serum directed against RBC antigens using indirect antiglobulin testing and antibody identification panels. Results are reviewed and transcribed into the electronic medical record; positive or clinically significant antibody identification triggers communication to the ordering provider, transfusion service notification if the patient may require blood products, and documentation in the prenatal chart for future transfusion planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | Use when 86870 is performed in addition to a separate, distinct laboratory procedure on the same day that is not normally reported together. |
90 |