How To Use CPT Code 85460

CPT 85460 describes the evaluation of fetomaternal hemorrhage using a differential lysis technique. 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 85460?

CPT 85460 can be used to evaluate fetomaternal hemorrhage by performing a differential lysis technique. This code is used when a lab analyst assesses whole blood from a patient who may have experienced fetomaternal hemorrhage to determine the amount of fetal cells mixing with maternal blood.

2. Official Description

The official description of CPT code 85460 is: ‘Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke)’

3. Procedure

1. The lab analyst performs the technical lab steps involving acid treatment of the maternal blood specimen.
2. This acid treatment allows for differential lysis and staining of fetal cells and maternal cells due to differences in hemoglobin Hb F versus Hb A.
3. The analyst evaluates the stained blood smear slide under the microscope to look for fetal cells in the maternal blood.
4. If fetal cells are identified, the analyst determines the percentage of fetal cells present in the slide of maternal blood and calculates the approximate volume of the fetal hemorrhage into maternal blood.
5. This method is also known as the Kleihauer-Betke test.

4. Qualifying circumstances

CPT 85460 is used when there is a need to evaluate the amount of fetal blood cells mixing with maternal blood. This test is often ordered when the maternal blood type is Rh negative and the fetal blood type is Rh positive. It helps determine the appropriate maternal Rh immunoglobulin dosage to prevent the formation of maternal antibodies that could harm the fetus. The test may also be ordered to assess fetal/placental trauma following abdominal trauma to a pregnant woman.

5. When to use CPT code 85460

CPT code 85460 should be used when there is a need to evaluate fetomaternal hemorrhage using the differential lysis technique. It is appropriate to bill this code when the lab analyst performs the acid treatment, differential lysis, staining, and evaluation of the blood smear slide to determine the presence and volume of fetal cells in maternal blood.

6. Documentation requirements

To support a claim for CPT 85460, the documentation should include:

• Indication for the test and the reason for evaluating fetomaternal hemorrhage
• Details of the acid treatment, differential lysis, staining, and evaluation process
• Findings of the test, including the presence or absence of fetal cells and the calculated volume of fetal hemorrhage
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 85460, ensure that the test is performed using the differential lysis technique. It is important to distinguish CPT 85460 from other codes that evaluate fetomaternal hemorrhage using different methods, such as the rosette test. Some payers may also separately reimburse for the collection of the specimen using a venipuncture code.

8. Historical information

CPT 85460 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst evaluates a blood sample from a pregnant woman to determine the volume of fetal cells mixing with maternal blood using the differential lysis technique.
2. After an abdominal trauma, a pregnant patient undergoes the Kleihauer-Betke test to assess the presence and volume of fetal cells in maternal blood.
3. A clinician orders CPT 85460 to determine the appropriate dosage of maternal Rh immunoglobulin for an Rh-negative mother carrying an Rh-positive fetus.
4. A lab analyst performs the differential lysis technique to evaluate fetomaternal hemorrhage in a patient with a history of Rh incompatibility.
5. Using CPT 85460, a lab analyst calculates the approximate volume of fetal hemorrhage into maternal blood to guide the management of a pregnant patient with suspected fetomaternal hemorrhage.
6. During a routine prenatal visit, a pregnant patient undergoes the Kleihauer-Betke test to assess the presence of fetal cells in maternal blood.
7. A lab analyst performs the differential lysis technique to evaluate fetomaternal hemorrhage in a pregnant patient with a history of previous pregnancies affected by hemolytic disease.
8. After an accident, a pregnant woman undergoes the Kleihauer-Betke test to assess the potential fetal/placental trauma.
9. A clinician orders CPT 85460 to evaluate fetomaternal hemorrhage in a pregnant patient with a positive antibody screen.
10. Using the differential lysis technique, a lab analyst determines the volume of fetal cells in maternal blood to guide the management of a pregnant patient with a suspected fetomaternal hemorrhage.