Find policies, billing codes, payers, states, and providers
CPT 86901: Serologic Rh Blood Group Typing, Serum or Plasma
CPT code 86901 represents a serologic test to identify a patient’s Rh blood group using serum or plasma. This laboratory procedure is central to transfusion safety, prenatal care, and preoperative evaluation, making it a routine yet clinically critical test across healthcare settings nationwide. Clear coding ensures proper claims processing and supports accurate tracking of immunohematology services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. The coverage landscape for Rh blood group testing is broadly established across public and private payers due to clinical necessity in transfusion medicine and obstetric care.
Readers will find a concise overview of the clinical context for Rh typing, typical sites of service, and related billing considerations. The publication outlines comparisons to closely related procedures (such as ABO typing), common use cases for 86901, and the typical diagnostic scenarios that justify the test. It also highlights payer coverage scope for major national payers and notes areas where policy language or coding guidance may affect submission and reimbursement. Data not available in the input will be explicitly identified where relevant.
Customize your policy alerts
Sign up for cpt 86901 policy alerts
Get alerted when payer policies referencing 86901 are released or updated.
Monitor payer policy activity
Billing Code Overview
CPT code 86901 describes a serologic Rh blood group test performed by a laboratory analyst to determine the patient’s Rh blood type using serum or plasma as the specimen. This service is classified as blood typing within the Rh system, distinct from ABO typing.
Service Type: Laboratory — blood bank / immunohematology testing
Typical Site of Service: Clinical laboratory or hospital laboratory (blood bank)
National Reimbursement Benchmarks
Commercial reimbursement for CPT 86901 centers around BUCA’s average commercial rate of $10.5, with notable variation across major national payers. Blue Cross Blue Shield shows the highest central tendency (median $15.1) and a wide upper bound (90th percentile $23.0), while Aetna and Cigna present much lower central values (medians $2.3 and $3.3 respectively). Cigna’s maximum is $13.1 and UnitedHealth Group’s median is $1.8, reflecting differing network pricing strategies.
Examining dispersion (P75 minus P25) highlights where rates cluster or diverge: Blue Cross Blue Shield has the widest interquartile spread at $7.0 ($19.2 − $12.2), indicating more variability in contracted rates, while UnitedHealth Group is the tightest at $1.7 ($3.0 − $1.3). Aetna’s spread is $1.7 ($3.7 − $2.0) and Cigna’s is $3.0 ($5.0 − $2.0), placing them between the extremes. BUCA’s quartiles (P75 $12.7, P25 $7.8) imply a moderate spread of $4.9 without min/max reporting.