2025 CPT code 85007
(Active) Effective Date: N/A Revision Date: N/A Pathology and Laboratory Procedures - Blood Count and Differential Hematology and Coagulation Procedures Feed
Manual differential white blood cell count from a blood smear, including red blood cell morphology and platelet estimation.
Modifiers may be applicable depending on the circumstances of service (e.g., 59 for distinct procedural service, 90/91 for outside/repeat testing). Consult your local Medicare Administrative Contractor (MAC) for specific guidance.
Medical necessity is established when the physician orders the test based on the patient's clinical presentation, including symptoms or suspected conditions. The test assists in the diagnosis, treatment, and monitoring of various infections, hematological disorders, or other conditions.
A laboratory technician or medical technologist performs this test. The physician orders the test and interprets the results in the context of the patient's clinical presentation.
In simple words: This lab test involves looking at a blood sample under a microscope to count and identify different types of white blood cells.This helps doctors understand if there is an infection or a blood disorder.
This CPT code encompasses the microscopic examination of a stained blood smear to manually count and differentiate white blood cells (WBCs), also known as leukocytes.The procedure involves evaluating the morphology (shape and size) of red blood cells (RBCs) and platelets, and classifying WBCs into their various types (lymphocytes, neutrophils, monocytes, eosinophils, basophils, and other types if present) based on their size, shape, maturity, and nuclear features. The manual differential typically counts 100 WBCs. This test helps distinguish between bacterial and viral infections and can reveal blood disorders such as leukemia. It may also be used to verify automated differential results or provide a more detailed evaluation of blood elements than automated analysis offers.
Example 1: A patient presents with symptoms of infection (fever, fatigue).The physician orders a complete blood count (CBC) with differential to determine the type and severity of the infection. An automated CBC is performed, but a manual differential (85007) is needed to clarify ambiguous results., A patient is undergoing chemotherapy for leukemia. Regular blood tests are required to monitor the treatment's effectiveness and detect any complications. A CBC with manual differential (85007) provides detailed information about the patient's blood cell counts and types, helping clinicians adjust the treatment accordingly., A patient presents with unexplained fatigue and bruising. The physician suspects a hematological disorder and orders a CBC with manual differential (85007).The manual differential aids in the identification of any abnormal cells or blood cell ratios, assisting in the diagnosis of potential blood disorders like leukemia or anemia.
Physician's order specifying the test;patient demographics; properly collected and labeled blood specimen; laboratory report with detailed results including WBC differential counts, RBC morphology description, platelet estimation, and any flagged abnormalities.
** Accurate and complete documentation is crucial for proper reimbursement.The presence of blasts, abnormal cell morphologies, or other abnormalities should be noted in the report.Pay close attention to NCCI edits and payer guidelines to avoid claim denials.
- Revenue Code: T1D (LAB TESTS - BLOOD COUNTS)
- RVU: This information is not available in the provided sources.Consult the current year's CPT codebook or a medical billing resource for RVU data.
- Global Days : Not applicable; this is a laboratory test.
- Payment Status: Active
- Modifier TC rule: Not applicable; this is a complete test.
- Fee Schedule : This information is not available in the provided sources. Fee schedules vary by payer and location.
- Specialties:Hematology, Oncology, Internal Medicine, Family Medicine, Pathology
- Place of Service:Office, Hospital (inpatient or outpatient), Clinical Laboratory, Other Place of Service