Billing Complete Blood Counts (CBC) Clarification
June 1, 2009Recent Comprehensive Error Rate Testing (CERT) analysis revealed an increase in errors due to incorrect coding for CPT 85025 and 85027. The findings show that providers are billing CPT 85027 when documentation supports CPT 85025.
| CPT: | Description: |
| 85025 | Complete Blood Count, with differential WBC, automated |
| 85027 | Complete Blood Count, automated |
A complete blood count consists of measuring a blood specimen for levels of hemoglobin, hematocrit, red blood cells, white blood cells, and platelets. Also, a differential white blood cell (WBC) count measures the percentages of different types of white blood cells. This hematology testing is commonly ordered by physicians to diagnose and treat a wide array of physical disorders. Laboratory test results that show automated CBC as well as the differential WBC support the use of CPT 85025 (provided the physician ordered them).
Another common error is billing of a CBC, when only hematocrit and hemoglobin laboratory tests have been completed. Providers are advised to make sure they are completing the tests ordered by the physician and only bill for tests actually completed on the bill to Medicare.