How To Use CPT Code 85007

CPT 85007 describes the microscopic examination and manual differential white blood cell (WBC) count performed by a lab analyst. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 85007?

CPT 85007 can be used to describe the microscopic examination and manual differential WBC count performed by a lab analyst. This code is used when the analyst examines stained blood smears under a microscope to count and differentiate the different types of white blood cells present in the sample.

2. Official Description

The official description of CPT code 85007 is: ‘Blood count; blood smear, microscopic examination with manual differential WBC count.’

3. Procedure

1. The lab analyst prepares a blood smear on a microscope slide and stains it with Wright stain.
2. The analyst examines the stained blood smear under a microscope, evaluating the morphology and abnormal appearance of red blood cells, platelets, and white blood cells.
3. A manual differential is performed by counting a specific number of white blood cells and categorizing them based on size, shape, maturity, and nucleus features.
4. The analyst records the differential count and provides a detailed report of the findings.

4. Qualifying circumstances

CPT 85007 is performed when a clinician requests a manual differential to confirm automated differential results or to obtain a more detailed evaluation of the blood elements. It is used to distinguish between bacterial and viral infections or to identify blood disorders such as leukemia. The test is performed by a lab analyst who examines the stained blood smears under a microscope and manually counts and differentiates the white blood cells.

5. When to use CPT code 85007

CPT code 85007 should be used when a clinician orders a microscopic examination and manual differential WBC count. It is appropriate when the automated differential results need confirmation or when a more detailed evaluation of the blood elements is required. This code should not be used for other types of blood counts or differentials.

6. Documentation requirements

To support a claim for CPT 85007, the lab analyst must document the following information:

• Reason for performing the manual differential
• Details of the microscopic examination, including morphology and abnormal appearance of blood elements
• Results of the manual differential count
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 85007, ensure that the test is performed by a lab analyst and that the documentation requirements are met. This code should not be reported with other blood count or differential codes. It is important to follow the specific billing guidelines of the payer to ensure accurate reimbursement.

8. Historical information

CPT 85007 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2003, when the description was updated to include the manual differential WBC count.

9. Examples

1. A lab analyst performs a microscopic examination and manual differential WBC count on a blood smear to evaluate a patient with suspected leukemia.
2. A clinician requests a manual differential to confirm the automated differential results for a patient with a suspected bacterial infection.
3. A lab analyst performs a microscopic examination and manual differential WBC count on a blood smear to assess a patient with an unknown blood disorder.
4. A clinician orders a manual differential to obtain a more detailed evaluation of the blood elements for a patient with abnormal automated differential results.
5. A lab analyst performs a microscopic examination and manual differential WBC count on a blood smear to differentiate between viral and bacterial infections in a patient with a high fever.
6. A clinician requests a manual differential to assess the white blood cell types and their proportions in a patient with an autoimmune disorder.
7. A lab analyst performs a microscopic examination and manual differential WBC count on a blood smear to evaluate a patient with suspected blood cancer.
8. A clinician orders a manual differential to obtain a more detailed analysis of the white blood cells in a patient with recurring infections.
9. A lab analyst performs a microscopic examination and manual differential WBC count on a blood smear to assess a patient with unexplained fatigue and weakness.
10. A clinician requests a manual differential to confirm the automated differential results for a patient with abnormal red blood cell morphology.