Charging for CPT 86903

[jphillips]

How are you charging for CPT 86903 Blood typing: antigen screening for compatible blood units using reagent serum per screened unit? According to the instructions 86903 should only be billed for each unit screened NOT for each antigen tested.

[Frances Haas]

:frown:We used to charge per antigen per unit. We found out at that, to be compliant with billing, we could have one charge for each unit, no matter how many antigens.

[tbostock]

Ditto for us; you are only allowed to charge per UNIT, not per antigen tested.

[kate murphy]

Yes, the CMS reimbursement rules have changed - per UNIT, not per ANTIGEN. So if you screen 10 units for K, you can charge 10, and if you screen 10 units for C,E,K Fya you can still only charge 10.

We changed our billing code from the patient, to the unit.

[DBRITT]

We only drop one charge per unit, but that charge is different depending on how many Antigens were screened for. If 1 then it's the Antigen 1charge, if 4 then it's the Antigen 4 charge on each unit

[LaraT23]

We have three different antigen groups, based on cost of the antisera. But we charge one per unit. So, the first group has CcEKMNA1Cw, so if you four units with any of those, charge 4. The next tier has the duffys, etc. But one charge per unit. We only charge one charge per unit ordered, so if the patient needs 4 units, and we typed 10 to find the four, we still can only charge 4.

[Eagle Eye]

Do you manually bill the patient or your computer system is set up to do that??

If you screen 10 units, i thought you should be able to charge for 10 units but only once regardless of antigens.???

[LaraT23]

We put the charges in manually. I am not sure how you could set that up automatically. The techs are the ones that know who and how many and of what tier really.

Not that CMS reimbursements cannot change, I will ask our consultant and get back to you on that one!

[LaraT23]

Just got it straight from our billing/medicare consultant that yes, we should be screening for each unit tested. That is even if the amount tested exceeds the number of units that are crossmatched.

Edited January 18, 2010 by LaraT23
misspelled

[Townsend]

We are using cpt code 86905 and billing per antigen/ per unit typed. We investigated this last year and found a reference in AABB's "Billing and Reimbursement / Frequently asked questions". The original question was regarding billing for matching units for sickle cell patients. You may still be able to pull this up on AABB's website.

Stephanie Townsend, MT (ASCP)SBB

[Mary**]

We have it set up to charge when each unit is resulted, i.e. K-, E-. It works great.