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Official Description

Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 86079 pertains to blood bank physician services specifically focused on the authorization for deviations from standard blood banking procedures. This code is utilized when a physician evaluates a batch of donated blood intended for transfusion into a patient. The physician's role involves a thorough analysis to ensure compatibility between the donor's blood and the recipient's blood type, as well as the identification of any unusual antibodies that may be present either in the patient's bloodstream or within the donated blood itself. Following this evaluation, the physician is required to document their findings in a written report, which serves as a formal record of the assessment and the rationale for any deviations from standard protocols. Such deviations may include the use of outdated blood or the transfusion of Rh incompatible units, which are critical considerations in ensuring patient safety during blood transfusions. It is important to note that this code should not be confused with CPT® Code 86078, which is applicable in cases where the physician investigates unusual occurrences after the blood has been transfused, such as potential disease transmission. Code 86079 is specifically designated for situations where the physician must authorize the use of blood that does not conform to standard blood banking practices.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The CPT® Code 86079 is indicated for use in specific scenarios where there is a need for a physician's authorization regarding deviations from standard blood banking procedures. These indications include:

  • Use of Outdated Blood The physician must authorize the transfusion of blood that has exceeded its shelf life, ensuring that the benefits outweigh the risks associated with using such blood.
  • Transfusion of Rh Incompatible Units The physician evaluates and authorizes the transfusion of blood that is not compatible with the recipient's Rh factor, which is critical for preventing hemolytic reactions.
  • Identification of Unusual Antibodies The physician assesses the presence of unusual antibodies in the patient's blood or the donated blood, which may necessitate deviations from standard procedures to ensure patient safety.

2. Procedure

The procedure associated with CPT® Code 86079 involves several critical steps that the physician must undertake to ensure the safe transfusion of blood. These steps include:

  • Evaluation of Donated Blood The physician begins by thoroughly analyzing the batch of donated blood. This includes checking the blood type and screening for any unusual antibodies that may pose a risk during transfusion.
  • Assessment of Compatibility The physician assesses the compatibility of the donated blood with the recipient's blood type, which is essential to prevent adverse reactions during the transfusion process.
  • Authorization of Deviation If any issues are identified, such as outdated blood or Rh incompatibility, the physician must make a clinical decision to authorize the deviation from standard procedures, weighing the potential risks and benefits.
  • Documentation of Findings After completing the evaluation and making a decision, the physician documents their findings and the rationale for the authorization in a written report. This report serves as a formal record of the assessment and is crucial for compliance and quality assurance.

3. Post-Procedure

After the procedure associated with CPT® Code 86079, the physician's responsibilities include monitoring the patient for any adverse reactions following the transfusion. It is essential to observe the patient closely for signs of hemolytic reactions or other complications that may arise from the use of blood that deviates from standard protocols. Additionally, the written report generated during the procedure should be retained in the patient's medical record for future reference and compliance purposes. This documentation is vital for ensuring that all deviations from standard blood banking practices are justified and that patient safety remains the top priority.

Short Descr PHYS BLOOD BANK SERV AUTHRJ
Medium Descr BLD BANK PHYS SVCS AUTHJ DEVIJ STANDARD REPRT
Long Descr Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator STV-Packaged Codes
Type of Service (TOS) 5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS) T1G - Lab tests - other (Medicare fee schedule)
MUE 1
CCS Clinical Classification 227 - Other diagnostic procedures (interview, evaluation, consultation)
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
91 Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient.
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GZ Item or service expected to be denied as not reasonable and necessary
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2013-01-01 Changed Short Descriptor changed.
Pre-1990 Added Code added.
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Description
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