Summary & Overview
CPT 86945: Laboratory Radiation Treatment of Blood
CPT code 86945 designates a laboratory procedure in which a blood specimen is treated with a radiation source by a laboratory analyst. The code is used to classify specialized in vitro processes involving radioactive materials applied to blood for diagnostic or preparatory purposes. Nationally, accurate coding of procedures that involve radiation handling is important for clinical documentation, regulatory compliance, and appropriate claims processing.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what the code represents, typical sites of service, and the clinical context in which the procedure is performed. The publication highlights benchmarks and policy-relevant items such as payer coverage considerations, coding guidance, and areas where clinical documentation commonly affects adjudication. Where input data is incomplete, the report notes that supplemental details are not available in the input.
This summary is intended for a national audience of billing managers, laboratory directors, and policy analysts seeking a high-level understanding of CPT code 86945, its clinical application, and payer relevance.
Billing Code Overview
CPT code 86945 describes a laboratory procedure in which a lab analyst treats a blood specimen with a radiation source as part of an in vitro diagnostic or laboratory preparation process. This procedure involves handling and applying controlled radioactive material to blood samples to achieve a specific analytical or therapeutic preparation outcome.
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Service type: Laboratory procedure involving radiation treatment of blood
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Typical site of service: Clinical laboratory or hospital laboratory setting
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred to a hospital or commercial clinical laboratory for therapeutic or investigational extracorporeal blood irradiation. The indication may include preparation of blood products or components for research, treatment of graft-versus-host disease risk in hematopoietic stem cell transplant settings, or specialized immunomodulatory treatment where blood or blood components require controlled exposure to a radiation source. The patient encounter is laboratory-based: a phlebotomy or blood-product collection is performed in an outpatient infusion center, transfusion service, or hospital blood bank; the collected specimen or product is transferred to a controlled radiation suite; a qualified laboratory analyst or technologist performs the procedural steps to expose the blood to a defined radiation dose; and the treated product is relabeled and returned for infusion, transfusion, storage, or further processing. Typical site of service is an acute care hospital blood bank, hospital outpatient infusion center, or licensed clinical laboratory. Patient monitoring is limited to standard transfusion/product handling safety checks; direct patient observation occurs during initial blood collection and subsequent infusion/transfusion as clinically indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the blood irradiation required substantially greater effort or complexity than typical laboratory processing. |