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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 medical condition known as autoimmune hemolytic anemia. The CPT® Code 86157 is specifically designated for the measurement of cold agglutinin titers, which quantifies the concentration of these antibodies in the blood. Elevated titers can be indicative of 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 be associated with conditions such as malaria, peripheral vascular disease, and common respiratory disorders. It is important to note that for screening tests to detect the presence of cold agglutinin antibodies, CPT® Code 86156 should be utilized. 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 determine the titer levels.
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Cold agglutinin titer testing is indicated for the evaluation of various conditions where cold agglutinin antibodies may be present. The following are specific indications for performing this test:
The procedure for measuring cold agglutinin titers involves several key steps that ensure accurate results. First, a blood sample is obtained from the patient through a process known as venipuncture. This procedure involves inserting a needle into a vein, typically in the arm, to draw blood. It is important to note that the venipuncture itself is a separately reportable procedure and should be documented accordingly. Once the blood sample is collected, it is processed to separate the serum from the cellular components. The serum is then subjected to a semi-quantitative hemagglutination test, which assesses the presence and concentration of cold agglutinin antibodies. This test involves mixing the serum with red blood cells at lower temperatures to observe any agglutination that occurs. The degree of agglutination is measured to determine the titer level, which indicates the concentration of cold agglutinins present in the serum.
After the cold agglutinin titer test is completed, the patient may experience minimal discomfort at the venipuncture site, which typically resolves quickly. There are no specific post-procedure care instructions required for patients following this test. However, it is essential for healthcare providers to monitor the results of the titer test in conjunction with the patient's clinical presentation and history. Elevated or low titers may necessitate further investigation or management based on the underlying conditions indicated by the test results. Additionally, healthcare professionals should ensure that the results are communicated effectively to the patient and documented in their medical records for future reference.
| Short Descr | COLD AGGLUTININ TITER | Medium Descr | COLD AGGLUTININ TITER | Long Descr | Cold agglutinin; titer | 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 |
| 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. | 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. |
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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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