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The CPT® Code 85004 refers to the procedure known as an automated differential white blood cell (WBC) count. This test is essential for quantifying the number of white blood cells, which are critical components of the immune system, in a specified volume of blood. The primary purpose of conducting a WBC count is to assess the overall health of an individual and to assist healthcare providers in diagnosing various medical conditions. These conditions may include infections, allergic reactions, systemic illnesses, inflammatory processes, and hematological disorders such as leukemia. The WBC count encompasses the evaluation of five distinct types of leukocytes: neutrophils, eosinophils, basophils, monocytes, and lymphocytes. In the automated version of this test, an electronic cell counter or an image analysis instrument is utilized to accurately count each type of white blood cell separately, providing detailed insights into the patient's immune status and potential underlying health issues.
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The automated differential WBC count (CPT® Code 85004) is indicated for various clinical scenarios where an assessment of the white blood cell population is necessary. The following conditions may warrant this procedure:
The automated differential WBC count involves several procedural steps to ensure accurate results. The following outlines the key steps involved in this laboratory test:
After the automated differential WBC count is performed, there are generally no specific post-procedure care requirements for the patient, as the test is minimally invasive and involves only a blood draw. Patients may experience slight discomfort or bruising at the puncture site, which typically resolves quickly. The results of the test are usually available within a short timeframe, allowing for timely clinical decision-making. It is important for healthcare providers to discuss the findings with the patient and consider them in conjunction with other clinical information to determine the appropriate course of action.
| Short Descr | AUTOMATED DIFF WBC COUNT | Medium Descr | BLOOD COUNT AUTOMATED DIFFERENTIAL WBC COUNT | Long Descr | Blood count; automated differential WBC count | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | CLIA Waived (QW) | No | APC Status Indicator | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1D - Lab tests - blood counts | MUE | 1 | CCS Clinical Classification | 233 - Laboratory - Chemistry and Hematology |
This is a primary code that can be used with these additional add-on codes.
| 0427U | New Code for 2024 Add on Code APC Q4 Monocyte distribution width, whole blood (List separately in addition to code for primary procedure) |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GA | Waiver of liability statement issued as required by payer policy, individual case | 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | Q4 | Service for ordering/referring physician qualifies as a service exemption | GW | Service not related to the hospice patient's terminal condition | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2003-01-01 | Added | First appearance in code book in 2003. |
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