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Official Description

Compatibility test each unit; antiglobulin technique

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 86922 refers to a compatibility test performed using the antiglobulin technique to assess the compatibility between a unit of blood and a recipient. This laboratory test is crucial in ensuring that the blood transfusion process is safe and effective, as it helps to prevent adverse reactions that can occur when incompatible blood types are mixed. Compatibility testing, often known as cross-matching (CM), is a vital step in the transfusion process. The antiglobulin technique is specifically employed when there is a positive result from a patient’s antibody screening test or if there is a documented history of clinically significant antibodies that could lead to complications, such as acute hemolytic transfusion reactions. The procedure involves the use of monoclonal antibodies, known as Coombs reagent, which target immunoglobulin G (IgG) and complement component 3 (C3). This allows for the detection of non-agglutinating red cell antibodies through an indirect antiglobulin test (IAT) or sensitized red cells through a direct antiglobulin test (DAT). The test is performed by mixing the patient’s red blood cells with the reagent and observing for agglutination, which indicates a reaction. The antiglobulin technique is essential for identifying potential incompatibilities that may not be detected by simpler methods, thereby enhancing patient safety during blood transfusions.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The compatibility test using the antiglobulin technique (CPT® Code 86922) is indicated in the following scenarios:

  • Positive Antibody Screening Test This test is performed when a patient has a positive result from an antibody screening test, indicating the presence of antibodies that may react with transfused blood.
  • History of Clinically Significant Antibodies The procedure is indicated for patients with a documented history of clinically significant antibodies, which are antibodies that have previously caused adverse reactions, such as acute hemolytic transfusion reactions.

2. Procedure

The procedure for conducting the compatibility test using the antiglobulin technique involves several critical steps:

  • Preparation of Samples Blood samples from both the recipient and the donor are prepared. The recipient's plasma or serum is separated from the red blood cells, and the donor's red blood cells are also isolated for testing.
  • Mixing with Coombs Reagent The recipient's red blood cells are mixed with a reagent containing monoclonal antibodies (Coombs reagent) that target IgG and C3. This mixture is essential for detecting any potential incompatibilities.
  • Observation for Agglutination The mixture is then observed for agglutination, which indicates a reaction between the recipient's antibodies and the donor's red blood cells. If agglutination occurs, it suggests incompatibility, and the unit cannot be transfused.
  • Incubation Technique (if applicable) In some cases, an incubation technique may be employed, where the recipient's red blood cells are warmed to 37°C for 30 minutes before observing for agglutination. This step is particularly relevant for detecting warm IgG autoantibodies.
  • Documentation of Results The results of the test, including any observed agglutination, are documented thoroughly to ensure accurate records for transfusion safety and compliance.

3. Post-Procedure

After the compatibility test using the antiglobulin technique is completed, the results must be carefully reviewed and documented. If the test indicates compatibility (no agglutination), the unit of blood may be safely transfused to the recipient. In cases where agglutination is observed, further investigation is required to determine the cause of the reaction, and the unit should not be transfused. It is also essential to monitor the patient for any signs of transfusion reactions during and after the transfusion process. Proper documentation of the test results and any subsequent actions taken is crucial for maintaining compliance and ensuring patient safety.

Short Descr COMPATIBILITY TEST ANTIGLOB
Medium Descr COMPATIBILITY EACH UNIT ANTIGLOBULIN
Long Descr Compatibility test each unit; antiglobulin technique
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
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 5
CCS Clinical Classification 235 - Other Laboratory
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.
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.
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.
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
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
2011-01-01 Changed Short description changed.
1993-01-01 Added First appearance in code book in 1993.
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