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The CPT® Code 86880 refers to the Antihuman globulin test, commonly known as the direct Coombs test, which is utilized in laboratory settings to measure the presence of antihuman globulin. This test is particularly significant in the diagnosis and management of hemolytic anemia, a condition characterized by the premature destruction of red blood cells due to antibodies that bind to these cells. The direct Coombs test is performed when there is a positive result from an antibody screening test for anti-globulins or when a patient exhibits symptoms indicative of hemolytic anemia. Symptoms may include pale skin, fatigue, weakness, and dizziness, which are manifestations of the underlying condition. Hemolytic anemia can arise from various causes, including autoimmune diseases such as systemic lupus erythematosus, malignant conditions like lymphoma or chronic lymphocytic leukemia, infections such as mycoplasma pneumonia and infectious mononucleosis, and adverse reactions to medications, including penicillin. Additionally, transfusion reactions can lead to hemolytic anemia. In newborns, exposure to maternal antibodies during pregnancy can result in hemolytic disease of the newborn. The test involves obtaining a blood sample through venipuncture, which is a separately reportable procedure, and the serum is then analyzed using hemagglutination techniques to determine the presence of antihuman globulin.
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The direct antihuman globulin test (Coombs test) is indicated in several clinical scenarios where the presence of antibodies against red blood cells may be suspected. The following conditions warrant the performance of this test:
The procedure for performing the direct antihuman globulin test (Coombs test) involves several key steps that ensure accurate results. First, a blood sample is obtained from the patient through a process known as venipuncture, which is a separately reportable procedure. This involves inserting a needle into a vein, typically in the arm, to collect the necessary blood specimen. Once the blood sample is collected, it is processed in the laboratory. The serum from the blood sample is then subjected to hemagglutination testing, a method that detects the presence of antibodies bound to red blood cells. During this testing, the serum is mixed with red blood cells that are known to be positive for specific antigens. If antihuman globulin is present in the serum, it will bind to the red blood cells, causing agglutination, which can be visually observed. The results of this test help determine whether hemolytic anemia is present and guide further clinical management.
After the direct antihuman globulin test (Coombs test) is performed, the laboratory will analyze the results and report them to the requesting physician. Depending on the findings, further diagnostic testing or clinical interventions may be necessary. If the test indicates the presence of antibodies, the physician may need to consider additional evaluations or treatments for the underlying cause of hemolytic anemia. Patients may be monitored for any symptoms related to hemolytic anemia, and follow-up care may be required to manage their condition effectively. It is essential for healthcare providers to communicate the results of the test to the patient and discuss any necessary next steps in their care plan.
| Short Descr | COOMBS TEST DIRECT | Medium Descr | ANTIHUMAN GLOBULIN DIRECT EACH ANTISERUM | Long Descr | Antihuman globulin test (Coombs test); direct, each antiserum | 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 | STV-Packaged Codes | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 4 | 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. | 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. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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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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