Pathology/Lab Coding Alert

Question: How should I report automated Hgb, Hct, RBC, WBC and platelet count with a manual differential WBC?

Answer: Old codes: Report 85023, Blood count; hemogram and platelet count, automated, and manual differential WBC count (CBC).

New codes: Report 85027, Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and 85007, ... blood smear, microscopic examination with manual differential WBC count. Because two codes now report the tests, you should be alert for payer restrictions on reporting these services together.

Question: How should I report automated Hgb, Hct, RBC, WBC and platelet count with an automated differential WBC?

Answer: Old codes: The answer depends on whether the differential WBC is partial or total. Report partial differential with 85024, Blood count; hemogram and platelet count, automated, and automated partial differential WBC count (CBC). Report compete differential WBC with 85025, Blood count; hemogram and platelet count, automated, and automated complete differential WBC count (CBC).

New codes: Whether partial or total differential, report 85025, Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count. Note that although the wording is different, the components of 85025 have not changed.

Question: How should I report an automated RBC, WBC, Hgb, Hct and indices, without platelets or differential WBC?

Answer: Old Codes: Report 85021, Blood count; hemogram, automated (RBC, WBC, Hgb, Hct and indices only).

New Codes: Because the new codes delete 85021, it appears that you must report each individual component - CPT 85014 , Blood count; hematocrit; 85018, Blood count; hemoglobin; 85041, Blood count; red blood cell (RBC); and 85048, Blood count; leukocyte (WBC), automated. Again, some payers may restrict this practice due to expense.

Because codes such as 85021, 85022 and 85023 were infrequently used, these deletions should have little impact on most labs

Tip: Update requisition forms to reflect the new codes, including the code definitions. This should minimize confusion regarding which tests are included in the CBC and eliminate orders for "hemogram," which is undefined in the new codes.