Pathology/Lab Coding Alert

Question: If the lab performs a “type and screen” for a blood transfusion, which procedure code(s) should I use?

Texas Subscriber

Answer: You need to know the lab method used for the type and screen to accurately answer the question, but we’ll assume that the lab uses some common serologic methods. Also, you don’t specify which typing tests, so we’ll assume ABO and Rh, which are the most clinically significant blood type systems. 

With those assumptions, the correct codes for the serologic blood typing are as follows: 

• 86900 — Blood typing; ABO
• 86901 — Blood typing; Rh (D).

In preparation for a blood transfusion, clinicians typically order antibody screening tests once the patient’s blood type is known in the ABO and Rh systems. A common test for serology antibody screen is 86850 (Antibody screen, RBC, each serum technique). This test looks for common antibodies that may cause a transfusion reaction, even if the donor and recipient share the same blood type in the ABO and Rh systems. 

A positive antibody screen means that red blood cell (RBC) antibodies are present in patient blood that could contraindicate a transfusion, but it does not identify the antibody. Following a positive RBC antibody screen, labs typically perform further testing to identify the antibodies present, such as 86870 (Antibody identification, RBC antibodies, each panel for each serum technique). 

Caveat: If the lab uses molecular or other methods for blood typing, the codes mentioned in this answer are not appropriate.