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An automated reticulocyte count is a laboratory procedure that quantifies the number of reticulocytes, which are immature red blood cells (RBCs) that are newly released from the bone marrow into the bloodstream. These reticulocytes typically circulate in the peripheral blood for a duration of 1 to 2 days before they mature into fully developed red blood cells. The primary purpose of performing a reticulocyte count is to assess the bone marrow's response to the body's demand for red blood cells, particularly in situations where there is a noted decrease in the overall red blood cell count, hemoglobin levels, or hematocrit measurements. This test is particularly useful in diagnosing and monitoring various medical conditions that affect red blood cell production and survival. Indications for conducting a reticulocyte count include conditions such as vitamin B12 or folate deficiency, which can impair red blood cell production; kidney disease, where erythropoietin production may be affected; and during or after chemotherapy or bone marrow transplant, where the bone marrow's ability to produce blood cells may be compromised. Additionally, patients receiving treatment with erythropoietin or darbepoetin, medications that stimulate red blood cell production, may also require monitoring of reticulocyte levels to evaluate the effectiveness of the treatment. The automated reticulocyte count is performed using specialized blood cell counting instruments, which provide a precise measurement of reticulocyte levels in the blood sample obtained from the patient. This procedure is reported with the CPT® code 85045 when performed independently, while additional cellular parameters can be measured using other specific codes.
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Vitamin B12 or Folate Deficiency Reticulocyte counts may be performed to evaluate the bone marrow's response to deficiencies in vitamin B12 or folate, which are essential for red blood cell production.
Kidney Disease In patients with kidney disease, the production of erythropoietin, a hormone that stimulates red blood cell production, may be impaired, necessitating monitoring of reticulocyte levels.
Chemotherapy Following chemotherapy, the bone marrow's ability to produce red blood cells can be affected, making reticulocyte counts important for assessing recovery and response to treatment.
Bone Marrow Transplant After a bone marrow transplant, monitoring reticulocyte counts helps evaluate the re-establishment of normal hematopoiesis and the effectiveness of the transplant.
Treatment with Erythropoietin or Darbepoetin Patients receiving erythropoietin or darbepoetin, medications that stimulate red blood cell production, require reticulocyte counts to assess the effectiveness of the treatment.
Step 1: A blood sample is obtained from the patient, typically through venipuncture, to ensure an adequate volume for testing.
Step 2: The blood sample is processed using an automated blood cell counting instrument, which performs the reticulocyte count. This instrument utilizes advanced technology to accurately measure the number of reticulocytes present in the sample.
Step 3: The automated system may also provide additional cellular parameters, such as reticulocyte hemoglobin content (CHr), immature reticulocyte fraction (IRF), mean reticulocyte volume (MRV), or RNA content, depending on the specific requirements of the test and the clinical context.
Step 4: The results of the reticulocyte count, along with any additional parameters measured, are then compiled and reported to the healthcare provider for interpretation and further clinical decision-making.
After the automated reticulocyte count is performed, the healthcare provider will review the results in conjunction with other laboratory findings and the patient's clinical history. Depending on the results, further diagnostic testing or treatment adjustments may be necessary. There are typically no specific post-procedure care requirements for the patient, as the blood draw is a routine procedure. However, patients may be advised to monitor for any unusual symptoms or complications related to the blood draw, such as excessive bleeding or infection at the puncture site.
| Short Descr | AUTOMATED RETICULOCYTE COUNT | Medium Descr | BLOOD COUNT RETICULOCYTE AUTOMATED | Long Descr | Blood count; reticulocyte, automated | 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 |
| 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 | GA | Waiver of liability statement issued as required by payer policy, individual case | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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. | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | GZ | Item or service expected to be denied as not reasonable and necessary | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | 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 | 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) | QW | Clia waived test |
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| 2003-01-01 | Changed | Code description changed. |
| 1990-01-01 | Added | First appearance in code book in 1990. |
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