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Cold agglutinins are specific antibodies produced by the immune system in response to certain infections. These antibodies can cause red blood cells (RBCs) to clump together, a process known as agglutination, particularly at lower body temperatures. This clumping can lead to significant complications, including the potential for damage or destruction of red blood cells, which may result in a condition known as autoimmune hemolytic anemia. The CPT® Code 86156 is designated for the screening test that detects the presence of cold agglutinin antibodies in the blood. It is important to differentiate this screening from the more specific measurement of cold agglutinin titers, which is reported under CPT® Code 86157. Elevated levels of cold agglutinins can be associated with various medical conditions, including infectious diseases such as mononucleosis, HIV, and atypical pneumonia caused by pathogens like mycoplasma, influenza A or B, parainfluenza, and adenoviruses. Conversely, abnormally low titers may indicate other health issues, such as malaria or peripheral vascular disease. The testing process involves obtaining a blood sample through venipuncture, which is a separately reportable procedure, and the serum is then analyzed using a semi-quantitative hemagglutination method to assess the presence and levels of these antibodies.
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Cold agglutinin screening is performed for various clinical indications, particularly when there is a suspicion of autoimmune hemolytic anemia or related conditions. The following are specific indications for conducting this test:
The procedure for cold agglutinin screening involves several key steps to ensure accurate results. The following outlines the procedural steps:
After the cold agglutinin screening procedure, patients may be monitored for any immediate adverse reactions to the venipuncture, such as bleeding or bruising at the site. There are typically no specific post-procedure care instructions required for this test, but patients should be advised to report any unusual symptoms or concerns to their healthcare provider. The results of the test will be communicated to the patient, and if elevated levels of cold agglutinins are detected, further diagnostic evaluation may be warranted to determine the underlying cause and appropriate management.
| Short Descr | COLD AGGLUTININ SCREEN | Medium Descr | COLD AGGLUTININ SCREEN | Long Descr | Cold agglutinin; screen | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | CLIA Waived (QW) | No | APC Status Indicator | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 235 - Other Laboratory |
| 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. | 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | Q4 | Service for ordering/referring physician qualifies as a service exemption | 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. | 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. | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study |
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| 2011-01-01 | Changed | Short description changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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