[MEDITECH-L] Need Help with CBC CPT Codes: Auto Diff vs. Manual Diff Added in LAB

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Pervine, Teresa

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Dec 8, 2009, 9:43:58 AM12/8/09

to medit...@mtusers.com

I need some help with CBC CPT codes. I am rebuilding the CBCs and want to make sure I am using the correct CPT codes. These are the codes I am currently planning to use:

The doctor orders a CBC with an auto diff: cpt code 85025.
The doctor orders a CBC with an auto diff and lab reflexes a manual diff due to indices meeting criteria for a manual diff: cpt codes 85027 and 85007.

Are these correct? Also, I'm not sure what cpt code/codes should be used if the doctor orders CBC with a manual diff. or if a CBC auto diff is ordered and a morphology review (or platelet scan) is reflexed by lab.

Any help would be appreciated.

Teresa Pervine MT (ASCP)
Clinical Support Specialist
Information Systems
Murray Calloway County Hospital
270-762-1160
tper...@murrayhospital.org

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Britt Watters

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Dec 8, 2009, 2:29:27 PM12/8/09

to Pervine, Teresa, Meditech L (meditech-l@MTUsers.com)

Hi Teresa,
These are the codes we use:
CBC w/auto diff (CBC): 85025
If a manual DIFF is reflexed, we use codes 85025 + 85027.

CBC w/manual diff (CBCD): 85027 + 85007 (This test has a unique charge code from the CBC test above, with a different charge since we do get reimbursed for doctor-ordered manual diffs, but not for manual diffs reflexed from a CBC order based on our lab criteria).

DIFF: Manual differential. No charge attached, so will only charge for physician-ordered diffs. If a physician requests a DIFF on a CBC order, we change the order to a CBCD for reimbursement purposes.

CBC w/reflexed Smear Review: 85025 + 85008
CBC, no diff: 85027

Hope this is helpful. I remember when I needed to figure it all out, my BAR person helped lot [that's as in the Meditech module, versus the local bartender..:)].