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An automated reticulocyte count is a laboratory test that measures 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 short duration of 1 to 2 days before maturing into fully developed RBCs. The reticulocyte count is particularly useful in assessing the bone marrow's response to the body's demand for red blood cells, especially in situations where there is a decrease in the overall RBC count, hemoglobin, or hematocrit levels. This test can provide critical insights into various medical conditions, including anemia, where the body may require an increased production of RBCs. The automated reticulocyte count is performed using advanced blood cell counting instruments that can provide precise measurements of reticulocytes along with additional cellular parameters. These parameters may include reticulocyte hemoglobin content (CHr), immature reticulocyte fraction (IRF), mean reticulocyte volume (MRV), and RNA content, all of which contribute to a comprehensive understanding of the reticulocyte population and their functionality. The CHr measurement indicates the amount of hemoglobin present in reticulocytes, serving as a marker for iron utilization in RBC production, which is essential for diagnosing conditions like iron deficiency anemia. The IRF helps in assessing whether reticulocytes are being released prematurely, which can occur in various clinical scenarios such as chronic kidney disease, following chemotherapy, or in patients with certain malignancies. The MRV provides information on the volume of reticulocytes relative to the total RBC count, aiding in the evaluation of iron utilization. Lastly, the RNA content analysis helps determine the maturity level of circulating reticulocytes, offering further insights into the bone marrow's activity and the overall health of the hematologic system.
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Decreased RBC Count A reticulocyte count may be performed when laboratory tests indicate a reduction in red blood cells (RBCs), hemoglobin, or hematocrit levels, which can suggest anemia or other hematologic disorders.
Vitamin B12 or Folate Deficiency Monitoring reticulocyte levels is important in patients with deficiencies in vitamin B12 or folate, as these nutrients are crucial for proper RBC production.
Kidney Disease In patients with chronic kidney disease, reticulocyte counts can help assess the bone marrow's response to the decreased erythropoietin production that typically occurs in this condition.
Chemotherapy Following chemotherapy, reticulocyte counts are monitored to evaluate the recovery of bone marrow function and the production of new RBCs.
Bone Marrow Transplant After a bone marrow transplant, reticulocyte counts are used to assess the re-establishment of hematopoiesis and the effectiveness of the transplant.
Treatment with Erythropoietin or Darbepoetin In patients receiving erythropoietin or darbepoetin therapy, reticulocyte counts are monitored to determine the effectiveness of the treatment in stimulating RBC production.
Step 1: Blood Sample Collection A blood sample is obtained from the patient, typically through venipuncture, ensuring that the sample is collected in a manner that prevents contamination and preserves the integrity of the blood cells for accurate analysis.
Step 2: Automated Reticulocyte Count The collected blood sample is then analyzed using an automated blood cell counting instrument. This instrument performs a comprehensive count of reticulocytes, providing a precise measurement of their quantity in the sample.
Step 3: Direct Measurement of Cellular Parameters In addition to the reticulocyte count, the automated system may also measure one or more cellular parameters, such as reticulocyte hemoglobin content (CHr), immature reticulocyte fraction (IRF), mean reticulocyte volume (MRV), and RNA content. Each of these parameters offers valuable insights into the characteristics and functionality of the reticulocytes, aiding in the overall assessment of the patient's hematologic status.
After the automated reticulocyte count is performed, the results are typically reviewed by a healthcare professional. The findings can provide critical information regarding the patient's bone marrow function and response to various conditions or treatments. Depending on the results, further diagnostic testing or clinical interventions may be warranted. Patients may not require any specific post-procedure care, but it is essential for healthcare providers to interpret the results in the context of the patient's overall clinical picture and any underlying conditions.
| Short Descr | RETICYTE/HGB CONCENTRATE | Medium Descr | BLOOD COUNT RETICULOCYTES AUTO 1/> CELL MEAS | Long Descr | Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content [CHr], immature reticulocyte fraction [IRF], reticulocyte volume [MRV], RNA content), direct measurement | 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. | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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. | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | GW | Service not related to the hospice patient's terminal condition | Q4 | Service for ordering/referring physician qualifies as a service exemption | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GZ | Item or service expected to be denied as not reasonable and necessary | 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. | 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 | 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 | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days |
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| 2010-01-01 | Changed | Code description changed. |
| 2009-01-01 | Changed | Code description changed |
| 2005-01-01 | Changed | Code description changed. |
| 1999-01-01 | Added | First appearance in code book in 1999. |
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