Summary & Overview
CPT 86900: ABO Blood Group Typing, Serum or Plasma
CPT code 86900 denotes laboratory ABO blood group typing performed on serum or plasma. This basic immunohematology test identifies a patient’s A, B, AB, or O blood group and is essential for transfusion safety, pretransplant evaluation, prenatal assessment, and many inpatient and outpatient clinical workflows. Nationally, ABO typing is a high-volume, routine laboratory service integral to blood banking and perioperative care.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides an operational and policy-focused view of CPT code 86900, covering clinical context, common sites of service, typical billing and service-line implications, and where available, payer coverage patterns and claims-handling considerations. It also summarizes common modifier usage and ancillary coding topics when relevant.
Readers will learn what CPT code 86900 represents clinically, how it is commonly deployed across laboratory and hospital settings, which payers commonly reimburse for the service, and what operational benchmarks and coding considerations typically accompany ABO blood typing. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 86900 describes a laboratory test in which the lab analyst determines the patient’s blood type within the ABO blood group system using serum or plasma as the specimen. This procedure identifies the patient’s A, B, AB, or O blood group and is a fundamental diagnostic service used to guide transfusion decisions, organ transplantation compatibility assessment, and other clinical care that depends on blood group status.
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Service type: Laboratory blood typing (ABO grouping) performed by a clinical laboratory analyst
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Typical site of service: Clinical laboratory or hospital laboratory setting
Clinical & Coding Specifications
Clinical Context
A 29-year-old pregnant woman presents for routine prenatal blood testing during her first trimester. The clinical laboratory receives a serum specimen to determine her ABO blood group as part of prenatal screening and transfusion preparedness. The lab analyst performs serologic testing using the patients serum or plasma to identify ABO antigens by mixing patient serum with reagent A and B antisera and observing agglutination patterns. Results are documented in the laboratory information system and reported to the obstetric provider and the blood bank to inform Rh and antibody testing, eligibility for certain transfusion products, and clinical management during delivery or potential bleeding events.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component if the laboratory separates technical and professional billing. |
59 | Distinct procedural service | Use when the ABO typing is distinct from other performed laboratory procedures on the same day and requires separate reporting. |