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86931 Frozen blood thaw

What 86931 is

CMS fee schedule short descriptor: Frozen blood thaw.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 86931 (CY2026)

This code has no Physician Fee Schedule rate: Statutory exclusion - not payable under the Physician Fee Schedule. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

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Medically Unlikely Edit (MUE)

Medicare caps 86931 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 86931? These codes are bundled into it

86931 is a Column 1 code in 2 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
86930Frozen blood prep1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair

86931 is bundled into these codes

86931 appears as a Column 2 code in 5 active edits. Reported with one of these Column 1 codes on the same date of service, 86931 is the code that denies.

Column 1 codeShort descriptionModifier indicator
86932Frozen blood freeze/thaw1Check pair
88241Frozen cell preparation0Check pair
P9039Rbc deglycerolized1Check pair
P9054Blood, l/r, froz/degly/wash1Check pair
P9057Rbc, frz/deg/wsh, l/r, irrad1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.