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The CPT® Code 85660 refers to the sickling of red blood cells (RBC), specifically the reduction of these cells during testing. This procedure involves analyzing a blood sample to detect the presence of hemoglobin S (HbS), which is an abnormal variant of hemoglobin. The sickling of RBC reduction test, commonly known as the HbS solubility test, is primarily utilized to screen for sickle cell anemia, a genetic disorder characterized by the transformation of normal round RBCs into a crescent or sickle shape. This condition predominantly affects individuals of African descent but can also be found in those of Mediterranean and Middle Eastern backgrounds. The sickled RBCs exhibit impaired flow through the circulatory system and are less effective in oxygen transport. Furthermore, these abnormal cells have a significantly reduced lifespan of approximately 10 to 20 days, compared to the normal lifespan of 120 days for healthy RBCs. As a result, individuals with sickle cell anemia may experience anemia due to the decreased number of circulating RBCs and may suffer from painful episodes caused by complications arising from the obstruction of small blood vessels by sickled cells. The HbS solubility test is performed by introducing a chemical agent to the blood sample, which diminishes the oxygen content. This reduction leads to the formation of polymers associated with hemoglobin S, causing the affected RBCs to sickle. The test is sensitive enough to identify even minimal quantities of hemoglobin S, making it a crucial tool for screening both sickle cell trait (where an individual carries one sickle cell gene) and sickle cell anemia (where an individual carries two sickle cell genes).
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The sickling of RBC reduction test (CPT® Code 85660) is indicated for the following conditions:
The procedure for the sickling of RBC reduction test involves several key steps to ensure accurate results:
After the sickling of RBC reduction test is completed, the patient may be advised on the following post-procedure considerations: monitoring for any immediate reactions to the blood draw, understanding the implications of the test results, and discussing potential follow-up testing or genetic counseling if the results indicate the presence of hemoglobin S. It is important for patients to be informed about the significance of their results, especially in the context of family planning and potential health implications associated with sickle cell disease.
| Short Descr | RBC SICKLE CELL TEST | Medium Descr | SICKLING RBC REDUCTION | Long Descr | Sickling of RBC, reduction | 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) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 2 | 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. | 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. | 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. | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study |
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| Pre-1990 | Added | Code added. |
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