Laboratory Question for the Week of March 3, 2025

Question:

When both qualitative and quantitative antibody tests are performed on the same specimen, should both tests be billed separately, or is only one reportable?

Answer:

Antibody testing can be qualitative (often mistakenly called “screening”) or quantitative. The quantitative testing is frequently a titer and linked to the qualitative test by reflex. Make sure your physicians have a choice with all reflex tests—they may not want the titer every time. According to past NCCI policy narrative guidance for sequential procedures (found in Transmittal 1746 at https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R1746CP.pdf), when both the qualitative and quantitative procedures are performed from the same specimen only the quantitative procedure is to be billed. “For example, when a cold agglutinin screen (code 86156) is positive for the presence of cold agglutinins and it is followed by a cold agglutinin titer (code 86157) in the same session, then the tests are considered sequential. Accordingly, the cold agglutinin titer (code 86157), which gives quantitative information, is the service that should be reported.”

This question was answered in our Coding Essentials for Laboratories. For more hot topics relating to laboratory services, please visit our store or call us at 1.800.252.1578, ext. 2.