How To Use CPT Code 85009

CPT 85009 describes the manual white blood cell (WBC) count using the buffy coat layer from a centrifuged blood specimen. 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 85009?

CPT 85009 can be used to describe the manual white blood cell (WBC) count using the buffy coat layer from a centrifuged blood specimen. This code is used when a lab analyst performs all the technical steps involved in extracting the buffy coat layer, smearing it on a slide, staining the slide, and manually counting the different types of white blood cells under a microscope.

2. Official Description

The official description of CPT code 85009 is: ‘Blood count; manual differential WBC count, buffy coat.’

3. Procedure

1. The lab analyst centrifuges the blood specimen to separate the buffy coat layer.
2. The lab analyst extracts the buffy coat layer, which contains white blood cells and platelets.
3. The lab analyst smears the buffy coat cells on a slide.
4. The lab analyst stains the slide to enhance the visibility of the white blood cells.
5. The lab analyst examines the slide under a microscope and manually counts the different types of white blood cells.

4. Qualifying circumstances

CPT 85009 is typically ordered by clinicians to determine if a patient’s white blood cells are in proper proportion or if there is an abnormally high or low count of specific white blood cell types. This test can help indicate the presence of certain diseases or conditions. While automated or manual differential WBC counts are more commonly ordered, CPT 85009 may be used to detect uncommon cells or organisms in the blood that suggest bacterial infection or certain malignant conditions.

5. When to use CPT code 85009

CPT code 85009 should be used when a manual differential WBC count using the buffy coat methodology is performed. It is important to note that this code should not be used if the buffy coat methodology is not utilized. In such cases, CPT code 85007 should be reported instead.

6. Documentation requirements

To support a claim for CPT 85009, the documentation should include:

• Reason for ordering the test and the clinical indication
• Details of the buffy coat methodology used
• Date and time of the procedure
• Results of the manual differential WBC count, including the counts of different white blood cell types
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 85009, ensure that the procedure involves the manual differential WBC count using the buffy coat methodology. It is important to note that this code should not be reported if CPT codes 85066 to 85076 have already been performed in the previous seven days. Additionally, some payers may separately reimburse for the collection of the blood specimen using a code such as 36415 for venipuncture.

8. Historical information

CPT 85009 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2003, when it was renamed to ‘Blood count; manual differential WBC count, buffy coat.’

9. Examples

1. A lab analyst performing a manual differential WBC count using the buffy coat methodology to assess a patient’s white blood cell composition.
2. A clinician ordering CPT 85009 to detect uncommon cells or organisms in the blood that may indicate a bacterial infection.
3. A lab technician manually counting the different types of white blood cells in a buffy coat slide to determine if a patient has an abnormally high or low count of specific white blood cell types.
4. A lab analyst using CPT 85009 to identify certain malignant conditions by examining the buffy coat cells under a microscope.
5. A clinician ordering a manual differential WBC count using the buffy coat methodology to assess a patient’s response to treatment for a specific disease or condition.
6. A lab technician performing a manual differential WBC count using the buffy coat methodology to detect any abnormalities in a patient’s white blood cell composition.
7. A clinician ordering CPT 85009 to investigate a patient’s persistent symptoms that may be related to an underlying blood disorder.
8. A lab analyst manually counting the different types of white blood cells in a buffy coat slide to monitor a patient’s response to a new medication.
9. A clinician ordering a manual differential WBC count using the buffy coat methodology to assess a patient’s immune system function.
10. A lab technician using CPT 85009 to detect any abnormalities in a patient’s white blood cell composition that may indicate an undiagnosed medical condition.