Pathology/Lab Coding Alert

Question: What is the correct code for a stool white blood cells (WBC) test? Physicians sometimes request this test in addition to a stool culture for patients with acute diarrhea.

Kansas Subscriber

Answer: CPT 2003 added a new code for stool WBC, also called a fecal leukocyte test. Physicians often order the test with a fecal culture, but you should report the two services separately.

The new CPT code is 89055 (Leukocyte count, fecal). Previously, Medicare provided a HCPCS Level II code for this procedure: G0026 (Fecal leukocyte examination). Because this was a temporary professional service code (G code), CMS deleted G0026 in the 2003 HCPCS with the advent of the new CPT code.

Prior to the addition of 89055, coders used a nonspecific CPT code to report fecal leukocytes to many payers other than Medicare. Because CPT added a more specific code, you should no longer report fecal leukocytes using 87205 (Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types).