Summary & Overview
CPT 86886: Indirect Antiglobulin (Coombs) Test with Serial Dilutions
CPT code 86886 represents the indirect antiglobulin (Coombs) test performed with serial dilutions of patient serum against test red blood cells to detect and characterize red cell–reactive antibodies. This laboratory serology procedure is a key diagnostic tool for immune-mediated hemolysis, pre-transfusion antibody identification workflows, and other immunohematology investigations, making it important for hospital and clinical laboratory operations nationwide. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise clinical and billing overview of the test, typical sites of service, and the implications for laboratory workflows. The publication summarizes national benchmarks and reimbursement context where available, highlights clinical relevance in transfusion and hemolytic anemia evaluation, and notes common billing modifiers used with laboratory procedures. Data limitations and missing input fields are explicitly identified where applicable. The piece is intended to inform laboratory managers, coding specialists, and health policy analysts about the role of CPT code 86886 in clinical practice and payer interactions, without making operational recommendations.
Billing Code Overview
CPT code 86886 describes an indirect antiglobulin (Coombs) test performed by a laboratory analyst using serial dilutions of patient serum against test red blood cells with known antibody and immunoglobulin class. The procedure identifies and characterizes antibodies in patient serum that react with red blood cells, aiding in the diagnosis of immune-mediated hemolytic anemia, antibody screening for transfusion compatibility, and related serologic investigations.
Service Type: Laboratory serology test (indirect antiglobulin/Coombs test) performed with serial dilutions
Typical Site of Service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A typical scenario involves an outpatient or inpatient blood bank laboratory analysis for a patient with suspected immune-mediated hemolysis, transfusion reaction, or prenatal evaluation for hemolytic disease of the fetus/newborn. A physician orders an indirect antiglobulin (Coombs) test to detect and characterize unexpected alloantibodies in patient serum that could react with donor red blood cells or fetal red cells.
The clinical workflow: a phlebotomy technician collects a serum sample, sends it to the immunohematology lab where a medical laboratory scientist or blood bank technologist performs 86886. The analyst incubates serial dilutions of patient serum with reagent red blood cells of known antigen profile, adds antihuman globulin reagent, and observes agglutination to determine antibody presence and titer and to help identify immunoglobulin class. Results are reported to the ordering clinician and the transfusion service; positive results may trigger further antibody identification panels, crossmatching, and changes to transfusion plans or obstetric management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component if separated from technical component |