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    v1.0.30
    OpenPayerBilling CodesHematology and Coagulation ProceduresCPT cpt-85004-automated-differential-white-blood-cell-count
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    CPT 85004: Automated White Blood Cell Differential

    CPT code 85004 describes an automated white blood cell differential in which a lab analyst reviews a blood smear on a slide and uses an automated system to count and classify the different types of white blood cells; service type: hematology/laboratory diagnostic test; typical site of service: clinical laboratory or hospital laboratory.

    For related coverage guidance, see recent payer policy updates: Hematology - Adzynma, Tumor Treating Fields for Pancreatic Cancer, Axicabtagene ciloleucel (Yescarta®) coverage.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a adult or pediatric outpatient presenting to a primary care clinic, urgent care, emergency department, or hospital inpatient unit with symptoms such as fever, malaise, cough, or suspected infection. The clinician orders a complete blood count with differential; a phlebotomist draws a blood specimen which is routed to the laboratory. In the lab, a technologist or lab analyst prepares a slide or loads the sample into an automated hematology analyzer that performs a white blood cell differential, enumerating neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Results are reviewed by the lab, validated, and reported to the ordering clinician to aid in diagnosis and management of infection, inflammation, hematologic disorders, medication effects, or monitoring of therapy (for example, chemotherapy or immunosuppression). Typical sites of service include outpatient clinics, urgent care centers, hospital laboratories, and reference laboratories. Workflow steps: order entry by clinician, specimen collection, specimen accessioning, analysis (manual review or automated differential), result validation, and result reporting into the medical record or lab information system.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    80053Comprehensive metabolic panel; blood chemistry profileOften ordered alongside a CBC with differential to assess electrolyte and organ function during acute illness
    80061Lipid panelMay be ordered in outpatient preventive or metabolic evaluations performed during the same visit
    81002Urinalysis, non-automated, without microscopyFrequently performed in the workup of infection or systemic illness alongside CBC with differential
    85014Blood count; automated differential WBC countRelated automated differential code; 85004 describes the lab analyst analyzing on a slide with automated system — 85014 is the automated differential often billed in similar workflows
    36415Collection of venous blood by venipunctureThe specimen collection procedure performed prior to laboratory analysis
    86353C-reactive protein; quantitativeAn inflammatory marker commonly ordered together with differential to assess acute inflammation

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    90Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208D00000X
    207R00000X
    207Q00000X
    207P00000X
    207L00000X
    156FX1900X
    2084P0802X
    364SM0705X

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    10 rows

    PolicyPayerEffective Date
    Hematology - AdzynmaCigna2026-10-15
    Tumor Treating Fields for Pancreatic Cancerselect_health2026-10-01
    Axicabtagene ciloleucel (Yescarta®) coverageBaylor Scott & White Health Plan2026-10-01
    Electric Tumor Treatment Field Therapy (for Kentucky Only)UnitedHealthcare2026-10-01
    Electric Tumor Treatment Field Therapy (for Kansas Only)UnitedHealthcare2026-10-01
    Electric Tumor Treatment Field Therapy (for Idaho Only)UnitedHealthcare2026-10-01
    Brexucabtagene autoleucel (Tecartus) CoverageBaylor Scott & White Health Plan2026-10-01
    Electric Tumor Treatment Field Therapy (for Pennsylvania Only)UnitedHealthcare2026-10-01
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Factor VIII ProductsCigna2026-09-15

    Related Codes

    CPT-85002-BLEEDING-TIME-TEST-LABORATORY

    CPT 85002: Bleeding Time Test, Technical Component

    CPT-85007-MANUAL-DIFFERENTIAL-WHITE-BLOOD-CELL-COUNT

    CPT 85007: Manual Differential White Blood Cell Count

    CPT-85008-BLOOD-SMEAR-MORPHOLOGIC-REVIEW-NO-DIFFERENTIAL

    CPT 85008: Microscopic Blood Smear Examination, No Differential

    CPT-85009-MANUAL-WBC-COUNT-BUFFY-COAT

    CPT 85009: Manual White Blood Cell Count Using Buffy Coat

    CPT-85013-MICROHEMATOCRIT-TEST-LABORATORY-DIAGNOSTIC

    CPT 85013: Microhematocrit Test by Tube Centrifugation

    CPT-85014-HEMATOCRIT-VOLUME-PERCENT-RED-BLOOD-CELLS

    CPT 85014: Hematocrit (Volume Percent of Red Blood Cells)

    CPT-85018-HEMOGLOBIN-ASSAY-WHOLE-BLOOD

    CPT 85018: Hemoglobin Measurement in Whole Blood

    CPT-85025-COMPLETE-BLOOD-COUNT-CBC

    CPT 85025: Complete Blood Count (CBC)

    CPT-85027-COMPLETE-BLOOD-COUNT-HGB-HCT

    CPT 85027: Complete Blood Count with Hemoglobin and Hematocrit

    CPT-85032-MANUAL-DIFFERENTIAL-BLOOD-SMEAR-COUNT

    CPT 85032: Manual Differential/Visual Cell Count

    Showing 1–10 of 99

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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