How To Use CPT Code 85013

CPT 85013 describes the procedure for a microhematocrit test, which is used to measure the percentage of red blood cell mass or volume in a small blood sample. 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 85013?

CPT 85013 is used to describe the procedure for a microhematocrit test, which measures the percentage of red blood cell mass or volume in a small blood sample. This test is typically performed by a lab analyst using a heparinized glass or plastic tube. The analyst seals one end of the tube, centrifuges the sample, and reads the results on a microhematocrit reader.

2. Official Description

The official description of CPT code 85013 is: ‘Blood count; spun microhematocrit.’

3. Procedure

1. The lab analyst collects a small blood sample using a heparinized microhematocrit tube, typically through a finger or heel stick.
2. The analyst seals the tube using a sealing clay to prevent any leakage.
3. The sealed tube is then placed in a centrifuge and spun at high speed to separate the red blood cells from the plasma.
4. After centrifugation, the analyst places the tube on a microhematocrit reader, which measures the actual hematocrit.
5. The reading obtained reflects the percentage of blood that is composed of red blood cells.

4. Qualifying circumstances

The microhematocrit test can be ordered by clinicians for various reasons, although it is commonly used to quickly check the red cell hematocrit in infants or when obtaining a venous blood sample is challenging. There are no specific qualifying circumstances for CPT code 85013, as it is a standalone procedure.

5. When to use CPT code 85013

CPT code 85013 should be used when performing a microhematocrit test to measure the percentage of red blood cell mass or volume in a small blood sample. It is important to note that this code should not be used for regular hematocrit or packed red blood cell volume tests, which have their own specific codes.

6. Documentation requirements

To support a claim for CPT code 85013, the documentation should include:

• Reason for performing the microhematocrit test
• Details of the procedure, including the use of a heparinized microhematocrit tube, sealing clay, centrifugation, and microhematocrit reader
• Date and time of the test
• Results of the test, indicating the percentage of red blood cell mass or volume
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT code 85013, ensure that the procedure is performed as described in the official description. There are no specific billing guidelines or modifiers associated with this code. It is important to note that CPT code 85013 should not be reported with other codes unless there are additional services or procedures performed.

8. Historical information

CPT code 85013 was added to the Current Procedural Terminology system on January 1, 1993. There have been no updates or changes to the code since its addition.

9. Examples

1. A lab analyst performing a microhematocrit test on a small blood sample obtained through a finger stick.
2. A clinician ordering a microhematocrit test for an infant to quickly check their red cell hematocrit.
3. A lab technician sealing a heparinized microhematocrit tube and placing it in a centrifuge for a microhematocrit test.
4. An analyst reading the results of a microhematocrit test on a microhematocrit reader and documenting the percentage of red blood cell mass or volume.
5. A lab performing a microhematocrit test on a blood sample to assess the red blood cell count in a patient with suspected anemia.
6. A clinician ordering a microhematocrit test when it is difficult to obtain a venous blood sample from a patient.
7. A lab analyst performing a microhematocrit test on a small blood sample collected through a heel stick.
8. A technician using a microhematocrit reader to measure the hematocrit of a blood sample obtained from a finger stick.
9. A clinician ordering a microhematocrit test to assess the red blood cell volume in a patient with polycythemia.
10. A lab analyst performing a microhematocrit test on a blood sample to monitor the response to a treatment for anemia.