2025 CPT code 85027
(Active) Effective Date: N/A Laboratory - Hematology and Coagulation Procedures Pathology and Laboratory Feed
Automated complete blood count (CBC) including hemoglobin, hematocrit, red blood cell (RBC) count, white blood cell (WBC) count, and platelet count.
Modifiers may be applicable in certain situations, such as repeat testing (modifier 91) or when distinct and separate services are performed by the same provider on the same day (modifier 59).
Medical necessity for 85027 must be supported by the patient's signs, symptoms, or diagnosis.Routine screening in the absence of medical indications is typically not covered.
Laboratory professionals perform the automated analysis of the blood sample.Physicians order the test and interpret the results in the context of the patient's clinical presentation.
In simple words: This is a common blood test that counts your different blood cells: red blood cells, white blood cells, and platelets. It also measures hemoglobin (which carries oxygen) and hematocrit (the percentage of red blood cells in your blood). This test helps doctors check for things like anemia, infection, and other blood disorders.
This code represents a fully automated complete blood count (CBC) that includes the following measurements: hemoglobin (Hgb), hematocrit (Hct), red blood cell (RBC) count, white blood cell (WBC) count, and platelet count.It does not include a manual or automated differential WBC count (which would be reported separately with 85007 or 85025, respectively). The test is typically performed using automated hematology analyzers.
Example 1: A 25-year-old female presents with fatigue and pallor. A CBC (85027) is ordered to assess for anemia., A 60-year-old male with a history of chemotherapy presents for routine monitoring. A CBC (85027) is ordered to monitor his blood cell counts., A 4-year-old child presents with fever and suspected infection.A CBC (85027) is ordered to evaluate for signs of infection, such as an elevated white blood cell count.
The documentation should include the reason for the CBC, relevant clinical findings, and the interpretation of the results.
- Payment Status: Active
- Specialties:Internal Medicine, Family Medicine, Pediatrics, Oncology, Hematology, Emergency Medicine
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Independent Laboratory, and other places of service where blood draws and laboratory tests are performed.