Pathology/Lab Coding Alert

Use new code for matching blood through lab information system The electronic compatibility test may save time and resources, but it doesn't save money if you don't get paid.
 
Now that CPT 2006 adds CPT 86923 for the procedure, you can learn how to get paid for the electronic crossmatch in uncomplicated transfusion cases. Bill 86923 for Computer Crossmatch In addition to type and screen, many hospitals use the common spin-technique compatibility test before transfusing blood (86920, Compatibility test each unit; immediate spin technique). But staff can work more efficiently when they do not need to pull segments and make red-blood-cell suspensions for the crossmatch, says Suzanne H. Butch, MA, MT(ASCP)SBB, administrative manager at University of Michigan's Blood Bank and Transfusion Services in Ann Arbor.
 
That's how 86923 (Compatibility test each unit; electronic) can help ease the transfusion work load for patients with two documented blood types and no clinically significant antibodies. CMS will pay $12.91 for the service.
 
Old way: Before CPT added the code, labs had to report the service with 99090 (Analysis of clinical data stored in computers [e.g., ECGs, blood pressures, hemato-logic data) -- which didn't get paid, Butch says. 'Type and Screen' Comes First Before receiving a blood transfusion, patients must undergo the following testing to avoid a dangerous transfusion reaction:
 
Blood typing -- "Blood type" refers to the presence or absence of certain antigens on the red-blood cell (RBC) surface. Of the more than 600 known antigens, the most significant in terms of transfusion compatibility are A, B and RhO(D). Two tests identify the patient's blood type under the ABO and Rhesus (Rh) systems.
 
• 86900 -- Blood typing; ABO
 
This test determines whether the patient is type A, B, AB or O.
 
• 86901 -- Blood typing; Rh(D)
 
This test determines whether the patient is Rh positive or negative (whether the patient has or does not have the RhO[D] antigen).
 
Patients must receive a compatible blood type in transfusion -- one that will not result in an antigen/antibody reaction.
 
Antibody screen -- Although not frequently occurring, certain antibodies to other antigens from the Rh or other systems, such as Duffy, Kell and Kidd, can also cause a transfusion reaction. "An antibody screen will detect the most common atypical IgG and some IgM antibodies," says Catherine Saporito, MT (ASCP), SBB, blood bank manager at University of Illinois Hospital in Chicago. A patient's blood undergoes the following test before a transfusion: 86850 -- Antibody screen, RBC, each serum technique. A negative antibody screen means that the patient has none of these common antibodies that could cause a transfusion reaction. A positive antibody screen means the presence of some antibody in the blood.  Know When to Use Compatibility Tests With a known blood type [...]