abbreviated panels

[LIMPER55]

Would you please help?

We have not historically charged for the abbreviated panels we perform,--for passive D siturations or selected cell panels.

Is there a CPT code we could use so we could capture these charges?

They are a lot of tech work.

[Malcolm Needs ☆]

I'm from the UK, so am not really on the same "wavelength" in terms of billing, but surely a panel is a panel? If you can prove or disprove the presence of a particular antibody specificity using fewer cells than normal (but more than a screen), then surely it is use of a panel?

Admittedly, we charge more to our hospitals if we use more than two standard panels, and even more if we use frozen reference cells or an unusual technique, but we charge the same for a full panel and an abbreviated panel.

[Likewine99]

We do an abbreviated panel on patients with documented evidence of Rhogam administration. It is charged as a regular panel.

We are located in suburban St. Louis, MO.

[LIMPER55]

Would you please help?

We have not historically charged for the abbreviated panels we perform,--for passive D siturations or selected cell panels.

Is there a CPT code we could use so we could capture these charges?

They are a lot of tech work.

ok---charging the abid cpt code will work. what antibody do you report ?

[David Saikin]

We charge for an antiboyd ID . . . we report anti-D, probably residual antenatal RhIg. and recommend a repeat 3-4 months after the last dose.

[Likewine99]

We report these abbreviated panels as "anti-D passive".

If we can't get a definite date of Rhogam administration we treat it like a "real anti-D', do the required selected cells and call it "anti-D".

[Malcolm Needs ☆]

As you may or may not know, in the UK, we measure anti-D in International Units per mL, rather than by titration. We report the antibody in different ways too!

If the anti-D is below 1.0 IU/mL, and we know that the lady has received anti-D immunoglobulin prophylaxis, we report it as "prophylactic".

If the anti-D is 1.0 IU/mL or above, we report it as "alloanti-D", and issue an antibody card.

If the anti-D is below 1.0 IU/mL, and we do NOT know that the lady has received anti-D immunoglobulin prophylaxis, we report it as "not specified".

If it is the baby of someone who has had prophylaxis during pregnancy, we report it as "passive".

If it is the baby of a lady with alloanti-D, we report it as "maternal".

So, that's nice and easy to get your head around!

It's even more complicated these days, with ITP patients receiving anti-D immunoglobulin!!!!!!!!!!!!!!

I sometimes feel like going back in time and sueing Levine and Stetson!!!!!!

:eyepoppin:eyepoppin:confuse::no::ohmygod:

[csjuarez]

Would you please help?

We have not historically charged for the abbreviated panels we perform,--for passive D siturations or selected cell panels.

Is there a CPT code we could use so we could capture these charges?

They are a lot of tech work.

I believe there may be a CPT code for ABID testing by per cell testing. The Red Cross in our area bills like this - sometimes by cell and sometimes by panel.

[tbostock]

We charge for a panel whenever we do an antibody ID. Sometimes you need to do all 11 cells of the panel, sometimes less if they have a previous antibody history, sometimes a few more cells to get all of the rule outs performed.

[bmarotto]

We use CPT code 86885 for each reagent red cell when running additional rule in/rule/out cells after the initial panel or when doing a selected cell panel on patients with previously identified antibodies.

[AMcCord]

We use CPT code 86885 for each reagent red cell when running additional rule in/rule/out cells after the initial panel or when doing a selected cell panel on patients with previously identified antibodies.

That's what we do. That's the code # that Claudia is talking about as well.

[MAGNUM]

we charge for the panel whether it be an abbreviated panel or the full blown panel

[adiescast]

We charge the full panel for the first workup whether we run 11 cells or not. If we run more than 11 cells, but fewer than 17, we add a partial panel charge. If we run 17 but fewer than 23, we charge a second full panel.

[bmarotto]

Funny thing...after I posted about 86885 last week I got this from our billing dept. They seem to think 86886 (antibody screen) and the 86885 are mutually exclusive. As an example, I gave them a bill we received from ARC Reference lab billing us one 86886, one 86870 (antibody ID panel) and fifty-six 86885 on the same patient draw. I have not heard back form them.

Here is information from the College of American Pathologists about the changes made to codes 86850 and 86885 in 2008. These two codes are mutually exclusive which means they cannot reasonably be performed at the same anatomic site or same patient encounter. "The deletion of antiserum from 86885 and 86886 code descriptors, the addition of reagent red cell to 86885, and antibody to 86886 characterize the 2008 revisions made to these antihuman globulin (Coombs) laboratory test codes.

Additionally, a new parenthetical note that directs the user to code 86850 for indirect antihuman globulin

testing for red blood cell antibody screening can be found below code 86886. A second parenthetical note

following code 86886 instructs the user to report code 86870 for indirect antihuman globulin testing for red

blood cell antibody identification using reagent red cell panels."

[L106]

Bev - I think this is some interesting information, and I really want to understant it. However, it's been a long day, and I'm having difficulty following what you are trying to explain. Is there any chance that you could reword some of your post to help me "get it?" (Again, strictly my problem!) Thanks!

Donna

[bmarotto]

Donna-It is complicated and I am not sure I get it either. Everything after the first paragraph (which is what I wrote) should be in red to designate the the e-mail I got from billing. What I think billing is saying, and I do not agree with, is that code 86850 (antibody screen) and 86885 (the code we use per cell tested for selected cell or partial panels) are mutually exclusive. I think they are quoting this statement from the January 2008 issue of CAP Today:

The deletion of “antiserum” from 86885 and 86886 code descriptors, the addition of “reagent red cell” to 86885, and “antibody” to 86886 characterize the 2008 revisions made to these antihuman globulin (“Coombs” ) laboratory test codes. Additionally, a new parenthetical note that directs the user to code 86850 for indirect antihuman globulin testing for red blood cell antibody screening can be found below code 86886. A second parenthetical note following code 86886 instructs the user to report code 86870 for indirect antihuman globulin testing for red blood cell antibody identification using reagent red cell panels.

I do not see where it says 86850 and 86885 are mutually exclusive. I interpret the final sentence as meaning we should use 86870 when doing an antibody ID using complete red cell panels. Testing patient plasma with individual cells (from one or multiple panels) using AHG method should be billed using the 86885 code per reagent cell tested. Prior to 2008, I believe CPT 86885 said per antiserum instead of per red cell tested. Anyway, our Red Cross reference lab is billing their workups the way I am billing our patients so I am not changing unless I hear otherwise from our billing department.

[L106]

Thank you! It makes a more sense now. I appreciate your help!

Donna

[Linda0623]

For those of you who charge for the 86885 for rule in/outs.......

do you: a) run both a full panel and charge 86870 for that and

chg 86855 via multiplier code for the number of rulein/out cells tested, (but is it a reportable test? if so, how do you answer both tests if there is only one antibody present?

or, do you order and charge for the full panel and rule outs by the individual reagent cell CPT 86855, and just result that as one "test".