Summary & Overview
HCPCS P2028: Cephalin Flocculation, Blood
HCPCS Level II code P2028 denotes cephalin flocculation testing on blood, a specialized serologic assay used in clinical laboratories to evaluate clotting function. Nationally, accurate coding for laboratory tests like P2028 supports clinical decision-making, quality measurement, and appropriate claims processing across public and commercial payers. Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of the clinical purpose of the test, typical site of service, and the payer landscape relevant to reimbursement and coverage. The publication summarizes coding context, common modifiers and procedural considerations when present, and highlights where input data is not available. It provides benchmarks and policy notes that affect billing consistency and claim adjudication for laboratory services, plus clinical context explaining when cephalin flocculation testing is ordered. This is intended for billing professionals, laboratory administrators, and policy analysts seeking a national-level briefing on how P2028 is represented in claims and coverage discussions.
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Billing Code Overview
HCPCS Level II code P2028 represents cephalin flocculation, blood, a laboratory serologic test that assesses clotting factor activity by observing flocculation in cephalin-based reagents. The service type is a diagnostic laboratory test, typically performed as a clinical pathology/laboratory service. The typical site of service is a clinical laboratory or hospital laboratory setting.
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Clinical & Coding Specifications
Clinical Context
A patient presents to the outpatient hematology or laboratory service for evaluation of a suspected coagulation disorder or monitoring of an existing bleeding disorder. Typical indications include unexplained bruising, mucosal bleeding, prolonged bleeding after a procedure, family history of bleeding diathesis, or abnormal screening coagulation tests. The clinician orders specialized platelet function and coagulation assays; one such test is the cephalin flocculation (also known as the kaolin-cephalin flocculation test) performed on a blood specimen.
The clinical workflow: the patient has blood drawn in the phlebotomy area of an ambulatory clinic, hospital outpatient lab, or inpatient ward. The sample is labeled and transported to the clinical laboratory. A medical laboratory technologist performs the cephalin flocculation assay, documents results in the laboratory information system, and the hematologist or ordering clinician reviews results and integrates them into the diagnostic workup or monitoring plan. Typical sites of service include hospital outpatient laboratory, independent clinical laboratory, and inpatient hospital laboratory.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional component of a laboratory test if applicable in mixed services (rare for waived or single-performer tests). |