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CodeMap Compliance Briefing: 05/13/05


Editor's Welcome:

For the past few years, many laboratories have shared frustration concerning the lack of guidance and resulting confusion concerning when it is appropriate to bill Medicare for reflex manual differentials. This situation represents one of the most common reflex testing scenarios. How should a lab submit claims to Medicare when the lab performs a complete blood count (CBC) with an automated WBC differential and the abnormal or inconclusive results require the performance of a manual WBC differential? CMS finally answered this question during the April 25th CMS Lab Open Door Forum by referring to recent changes to the National Correct Coding Policy Manual. Please let us know if you have any questions on this or any other issue concerning coding, reimbursement, and/or compliance.

Sincerely,

Charles Root, Ph.D.

History and Background on Reflexed Manual Differentials

CPT code 85023, Automated CBC with manual WBC differential was deleted from the 2003 ....

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