Laboratory Question for the Week of November 5, 2018

Laboratory Compliance Question of the Week

Question:

Can labs report CPT code 85007 or CPT code 85008 for examining a blood smear to complete an ordered automated hemogram test (CPT codes 85025 or 85027)?

Answer:

If a treating physician orders an automated complete blood count with an automated differential WBC count (CPT code 85025) or without one (CPT code 85027), a lab sometimes examines a blood smear in order to complete the ordered test based on lab-selected criteria flagging the results for additional verification.

However, according to the National Correct Coding Initiative Manual for Medicare Services, the lab should NOT report either of the following codes for the blood-smear exam to complete the ordered automated hemogram (85025 or 85027):

85007 Blood count; blood smear, microscopic examination with manual differential WBC count
85008 Blood smear, microscopic examination without manual differential WBC count

The same principle applies if the treating physician orders any type of blood count, and the lab’s practice is to perform an automated CBC with or without automated differential WBC count.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.