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).
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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.