How To Use CPT Code 85025

CPT 85025 describes the complete blood count (CBC) test, which provides detailed information about various types of cells in a patient’s blood. 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 85025?

CPT 85025 is used to report the complete blood count (CBC) test, which is a blood test that provides detailed information about different types of cells in a patient’s blood. This test is typically requested by a doctor to assess a patient’s overall health and diagnose various conditions. The CBC test measures the levels of hemoglobin, hematocrit, red blood cells, white blood cells, and platelets in the blood.

2. Official Description

The official description of CPT code 85025 is: ‘Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count.’

3. Procedure

1. The healthcare professional collects a small amount of the patient’s blood using a syringe.
2. The blood is then transferred to a test tube containing an anticoagulant to prevent clotting.
3. The blood sample is transported to the laboratory for analysis.
4. In the laboratory, an automated analyzer is used to count and measure the different types of cells in the blood.
5. The results of the CBC test, including the levels of hemoglobin, hematocrit, red blood cells, white blood cells, and platelets, are generated and reviewed by a pathologist or technician.
6. The final results are provided to the requesting doctor for further evaluation and diagnosis.

4. Qualifying circumstances

CPT 85025 can be used for patients who require a complete blood count (CBC) test to assess their overall health or diagnose specific conditions. This test is commonly performed as part of routine check-ups, pre-operative evaluations, or to monitor the progress of certain diseases or treatments. The CBC test can help detect anemia, infections, blood disorders, and other medical conditions.

5. When to use CPT code 85025

CPT code 85025 should be used when a complete blood count (CBC) test is performed using automated methods to measure the levels of hemoglobin, hematocrit, red blood cells, white blood cells, and platelets in the blood. This code is appropriate for both inpatient and outpatient settings.

6. Documentation requirements

To support a claim for CPT 85025, the healthcare professional must document the following information:

• Reason for performing the CBC test
• Date and time of the test
• Results of the CBC test, including the levels of hemoglobin, hematocrit, red blood cells, white blood cells, and platelets
• Signature of the healthcare professional performing or reviewing the test

7. Billing guidelines

When billing for CPT 85025, ensure that the test was performed using automated methods and includes the complete blood count (CBC) and automated differential white blood cell (WBC) count. It is important to follow the specific guidelines and requirements of the payer when submitting the claim. CPT code 85025 should not be reported with other codes that include a complete blood count (CBC) test.

8. Historical information

CPT 85025 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes a complete blood count (CBC) test to assess their overall health during a routine check-up.
2. A doctor orders a CBC test to monitor the progress of a patient’s chemotherapy treatment.
3. A pre-operative evaluation includes a CBC test to ensure the patient is in good health before surgery.
4. A patient with symptoms of anemia undergoes a CBC test to determine the cause of their condition.
5. A patient with a suspected infection has a CBC test to assess their white blood cell count.
6. A CBC test is performed on a newborn baby to screen for any blood disorders.
7. A patient with a known blood disorder undergoes regular CBC tests to monitor their condition.
8. A CBC test is performed on a patient with unexplained fatigue and weakness to investigate potential underlying causes.
9. A patient with a history of bleeding disorders has a CBC test to assess their platelet count.
10. A CBC test is ordered for a patient with symptoms of inflammation to evaluate their white blood cell count.