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Test Code Billings Clinic: 1032 White Blood Cell (WBC) Count and Differential, Blood

Performing Laboratory

Billings Clinic Laboratory: Hematology

Useful For

  • Screening tool to confirm a hematologic disorder
  • Establish or rule out a diagnosis
  • Detect an unsuspected hematologic disorder
  • Monitor effects of radiation or chemotherapy
  • These counts are used as clinical guides in the diagnosis and/or monitoring of many diseases

Methodology

Flow cytometry

Specimen Requirements

  • Specimen must arrive within 24 hours of draw.
  • Draw blood in a lavender-top (EDTA) tube(s), and send 5 mL of unprocessed EDTA whole bloodrefrigerated.
  • Do not centrifuge.
  • Forward unprocessed whole blood promptly.

Reject Due To

  • Clotted specimens
  • Specimens containing small clots, fibrin strands or platelet clumps
  • Gross hemolysis
  • Samples drawn above an IV line
  • Samples kept at room temperature > 24 hours after collection

**Lipemia, icterus and cold agglutinins may affect the test results.

Reference Values

  • Reference values are included with patient’s report.
  • Call-back value: 
    • WBC <2,000/µL or >50,000/µL
  • Note:  If blasts are present, treating physician will be contacted.

Day(s) Test Set Up

Daily

Test Classification and CPT Coding

85004 - Blood count; automated differential WBC count

85007 - manual differential WBC count (if appropriate)
85008 - manual blood smear (if appropriate)

 

LCD or NCD test. ICD-10 code is required for this test. When appropriate, obtain a properly executed ABN and submit the ABN with test order(s). See “Medical Necessity and Advanced Beneficiary Notice (ABN) Policy and Form” under Resources for a copy of a form and additional information.

LOINC Code Information

Reporting Name LOINC Code
WBC 6690-2
Neutrophils 751-8
Lymphocytes 731-0
Monocytes 742-7
Eosinophils 711-2
Basophils 704-7

 

Profile/Testing Information

Reflex Information:

1. Reflex smear review testing (85008**) at a charge of $0.00 occurs when:

  • WBC for Inpatients and Advanced Care patients is <2,400 or >20,000
  • WBC for Reference and Clinic patients is <3,200 or> 18,000
  • WBC for Family Birth Center patients is <2,400 or> 25,000
  • WBC for Oncology Outpatients is <1,000 or >18,000

2. Reflex manual WBC differential testing (85007**) may occur when:

  • WBC for ED or SDC is <3,200 or >18,000
  • Blasts, promyelocytes, myelocytes, and metamyelocytes total> 5% or
  • Variant lymphocytes >25% or
  • Bands >15%

In the event that a peripheral blood smear interpreted by a physician with a written report (85060) is indicated, Billings Clinic Laboratory will call the ordering physician/nonphysician provider (NPP) and request a specific order for this test.

 

When the automated results can not be reported, the test is not a true “reflex” situation. Thus when further testing must be completed in order to issue a report, CMS considers such further testing to be part of the required procedure required to fulfill the physician/NPP’s order. In such cases, only the testing ordered is billed.