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Pathology/Lab Coding Alert

READER QUESTIONS:

Use Blood Type Encounter for Rh Test

Published on Tue Mar 14, 2006

Question: What would be the better diagnosis code to use for a husband coming in to test for his Rh antibody status because his wife has had multiple miscarriages--V77.99 or V78.9? What is the correct procedure code for the lab test?


Mississippi Subscriber
Answer: You should not use V77.99 (Special screening for other and unspecified endocrine, nutritional, metabolic, and immunity disorders) or V78.9 (Special screening for unspecified disorder of blood and blood-forming organs) because the Rh factor is not a disease condition.

Although you won't find a code that specifically mentions an Rh antibody status test, you should use the most specific code available--which would be the new code V72.86 (Other specified examinations; encounter for blood typing). ICD-9 added this code for just this purpose, and it became effective Oct. 1, 2005.

The correct procedure code for the Rh antibody blood test is 86901 (Blood typing; Rh [D]). The test identifies the presence (Rh positive) or absence (Rh negative) of Rh antigens on the patient's red blood cells. The father's Rh status can contribute to hemolytic disease of the fetus or newborn due to Rh isoimmunization (773.0).

If the lab performs more extensive Rh phenotyping to further identify Rh antigens detected by screening, report 86906 (Blood typing; Rh phenotyping, complete) in addition to the original screening (86901).
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