Summary & Overview
CPT 85013: Microhematocrit Test, Laboratory Diagnostic
CPT code 85013 denotes the microhematocrit test, a common laboratory procedure used to measure packed cell volume by centrifuging a heparinized capillary tube and reading the sample on a microhematocrit reader. The test is a fundamental, rapid diagnostic tool in clinical and hospital laboratories for assessing anemia, polycythemia, and monitoring fluid status. Nationally, this code is used across inpatient and outpatient laboratory settings and is relevant for clinicians, lab managers, and payers because of its frequent use in acute and routine care workflows.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise information on what the code represents, typical sites of service, and operational context for billing and documentation. The publication summarizes clinical context and service type, and identifies common modifiers and payer considerations where available. Data not available in the input is noted where applicable.
This report provides a practical reference for coding staff, laboratory leadership, and billing professionals seeking to understand the clinical purpose of 85013, typical settings where it is performed, and the payer landscape relevant to reimbursement and workflow integration.
Billing Code Overview
CPT code 85013 describes a microhematocrit test performed by a laboratory analyst. The procedure typically uses a heparinized glass or plastic tube, which is sealed at one end, then centrifuged and read on a microhematocrit reader to determine the packed cell volume.
Service Type: Laboratory diagnostic test
Typical Site of Service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A typical patient is a 65-year-old man admitted to an inpatient medical ward for evaluation of anemia and shortness of breath. The clinician orders a microhematocrit to quickly assess packed cell volume at the bedside. A phlebotomy technician or laboratory analyst collects a capillary or venous blood specimen into a heparinized microhematocrit tube, seals one end with clay or sealant, and places the tube in a microhematocrit centrifuge. After centrifugation (typically 3–5 minutes at high speed), the analyst reads the packed red cell column using a microhematocrit reader and documents the percent hematocrit in the laboratory information system.
Typical workflow steps:
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Provider order placed in the electronic medical record for a microhematocrit (
85013). -
Phlebotomy or bedside nurse collects sample using heparinized microcapillary tube and seals tube.
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Lab analyst centrifuges tubes and reads hematocrit on a microhematocrit reader.
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Result reported as percent packed cell volume; values used for immediate clinical decisions such as transfusion threshold, anticoagulation adjustments, or further laboratory workup.
Typical site of service: hospital inpatient ward, emergency department, outpatient clinic laboratory, or bedside point-of-care setting.
Typical patient scenario: urgent assessment of anemia in the ED or rapid pre-transfusion hematocrit check on a medical-surgical floor prior to blood product administration.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Provider's usual, customary, and reasonable (default) | Use when physician performs or oversees the service under normal circumstances. |
26 | Professional component | Use when billing only the professional interpretation or supervision portion, if separated from the technical component.
TC | Technical component | Use when billing only the technical component (equipment, technician, centrifugation, reading) of the test.
59 | Distinct procedural service | Use when the microhematocrit is separate and distinct from other services on the same day (e.g., separate venipuncture for a point-of-care test).
90 | Reference (outside) laboratory | Use when the test was performed by an independent outside laboratory and testing was outsourced.
91 | Repeat clinical diagnostic laboratory test | Use when repeating a test on the same day for monitoring or verification.
52 | Reduced services | Use when the service performed is partially reduced or not completed as described by the full code.
53 | Discontinued procedure | Use when the procedure is started but discontinued due to patient condition.
76 | Repeat procedure by same provider | Data not available in the input.
77 | Repeat procedure by another provider | Data not available in the input.
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207P00000X | Pathology | Laboratory directors and clinical pathologists who oversee hematology testing and quality control. |
390200000X | Phlebotomy | Personnel who obtain blood specimens and may perform point-of-care microhematocrit collection.
208D00000X | Diagnostic Laboratory | Medical laboratory technicians/technologists who perform centrifugation and reading of microhematocrits.
207L00000X | Hematology | Hematologists who interpret hematocrit results within broader anemia workups.
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
D50.9 | Iron deficiency anemia, unspecified | Common cause of low hematocrit; microhematocrit provides rapid estimate of severity. |
D64.9 | Anemia, unspecified | Used when anemia is suspected and a quick hematocrit helps initial assessment.
D62 | Acute posthemorrhagic anemia | Microhematocrit used for rapid assessment following acute blood loss to guide transfusion.
R58 | Hemorrhage, not elsewhere classified | In active bleeding, microhematocrit can be a rapid bedside measure to evaluate blood loss.
I21.9 | Acute myocardial infarction, unspecified | Hematocrit may be checked rapidly in acute coronary syndrome patients prior to interventions.
Z51.11 | Encounter for antineoplastic chemotherapy | Patients on chemotherapy are frequently monitored for anemia with quick hematocrit checks prior to treatment.
Z51.81 | Encounter for therapeutic drug level monitoring | Represents settings where frequent point-of-care hematocrit monitoring may be needed during therapy.
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
85014 | Erythrocyte sedimentation rate by automated method | Often ordered alongside microhematocrit in anemia or inflammatory evaluations; different hematology test performed in the lab. |
85025 | Blood count; automated (RBC count, hemoglobin, hematocrit, WBC, platelet, and RBC indices) | Comprehensive CBC often performed before or after a microhematocrit; provides automated hematocrit and additional parameters.
36415 | Collection of venous blood by venipuncture | Specimen collection code commonly billed when venous blood is drawn for microhematocrit or accompanying tests.
99000 | Handling and/or conveyance of specimen | Ancillary service sometimes used by facilities for processing or transport of lab specimens (facility-specific billing practices).
82947 | Glucose; quantitative, blood (except reagent strip) | Point-of-care or stat laboratory tests frequently ordered concurrently in emergency or preoperative evaluations.