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BETA v.3.0

2025 CPT code 86904

Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened.

Report 86904 for each unit of blood screened. Do not report this code for routine ABO/Rh typing. This code is only for antigen screening beyond the basic ABO/Rh system.

Modifiers may be applicable in certain situations. For example, modifier 59 may be used to indicate a distinct procedural service.

Medical necessity for this code is established by the clinical need for a blood transfusion. The antigen screening is necessary to ensure the safety and efficacy of the transfusion by preventing potentially life-threatening transfusion reactions.

The laboratory analyst performs the technical aspects of the test, which includes mixing the patient's serum with donor red blood cells and observing for any reactions (agglutination or clumping). Ordering and interpretation of the test results are the responsibility of the physician.

In simple words: This test checks if a unit of donated blood is safe for you to receive. It looks for substances in the donated blood that might cause your body to reject the transfusion. The test is done separately for each unit of blood.

This code represents the process of screening a unit of donor blood for compatibility with a recipient's serum. It involves testing the donor blood against the recipient's serum to detect the presence of any antigens that might react with the recipient's antibodies. This procedure is distinct from ABO/Rh typing and is performed for each unit of blood being considered for transfusion.

Example 1: A patient requires a blood transfusion due to significant blood loss after surgery. Before transfusing, the patient’s serum is screened against several units of donor blood using code 86904 to ensure compatibility and minimize the risk of transfusion reactions., A pregnant woman with a rare blood type requires a blood transfusion. The blood bank uses 86904 to screen multiple donor units to find a compatible match, given the potential for complications due to the rarity of the blood type., A patient with a history of multiple blood transfusions has developed several antibodies to different blood antigens. Before their next transfusion, an extensive antigen screen (86904) is performed on donor units to prevent a potential hemolytic transfusion reaction.

Documentation should include the reason for the blood transfusion, the recipient's blood type and any known antibodies, the donor unit information including blood type, the results of the compatibility testing, and any observed reactions.

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