Summary & Overview
CPT 90386: Rho(D) Immunoglobulin to Prevent Hemolytic Disease of the Newborn
CPT code 90386 denotes Rho(D) (Rhesus D) immunoglobulin, a plasma‑derived antibody preparation used to provide passive immunity and prevent Rh alloimmunization and hemolytic disease of the newborn. Nationally, this code covers a critical preventive intervention in obstetric care that reduces morbidity associated with Rh incompatibility and supports maternal and neonatal safety.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the product and its typical sites of service, plus an overview of payer coverage considerations and common billing modifiers. The publication summarizes reimbursement benchmarks where available, highlights relevant policy and coverage updates impacting access, and clarifies billing and coding practices tied to this injectable biologic.
This resource is intended for billing professionals, practice managers, and policy analysts seeking a clear, national‑level briefing on clinical use, coding designation, and payer coverage patterns for Rho(D) immunoglobulin under CPT code 90386.
Billing Code Overview
CPT code 90386 describes Rho(D) (Rhesus D) immunoglobulin derived from plasma of healthy, specifically immunized human donors. This biologic provides passive immunity by supplying anti-Rh(D) antibodies to prevent Rh (Rhesus) alloimmunization and hemolytic disease of the newborn.
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Service type: Administration of Rho(D) immunoglobulin as a passive immunization therapy
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Typical site of service: Outpatient clinic, obstetrics clinic, hospital outpatient department, or other ambulatory care settings where injectable biologics are administered
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A 28-year-old Rh-negative pregnant woman presents at 28 weeks' gestation after her routine prenatal antibody screen returns negative for anti-D but she reports a recent motor vehicle collision with abdominal trauma. The obstetrician documents potential fetal-maternal hemorrhage risk and orders administration of Rho(D) immune globulin to prevent alloimmunization. The clinical workflow includes informed consent, verification of patient Rh status and prior sensitization history, calculation of dose based on gestational age and exposure risk (standard antepartum dose or additional postpartum dose if indicated), preparation and administration of 90386 intramuscularly or intravenously per product labeling, and documentation of lot number, expiration, site of injection, and any adverse reactions. Follow-up includes repeat antibody screen at appropriate interval and documentation in maternal record.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Not typically reported; use when no modifier applies |
22 | Increased procedural services |