Summary & Overview
CPT 85014: Hematocrit (Volume Percent of Red Blood Cells)
CPT code 85014 represents a laboratory measurement of hematocrit—the volume percent of red blood cells in a whole blood specimen. Hematocrit is a routine diagnostic parameter used in assessing anemia, polycythemia, hydration status, and other hematologic conditions. Nationally, this code underpins frequent laboratory workstreams across outpatient clinics, hospital labs, and reference laboratories and therefore factors into volume-driven lab payment considerations and testing workflows.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the test, typical sites of service, and common billing considerations. The publication summarizes available national benchmarks for utilization and reimbursement where provided, highlights relevant coding considerations for laboratory service lines, and outlines implications for billing operations and claims processing.
The content is intended for a national audience of billing managers, laboratory directors, and policy analysts who need a clear reference on the clinical purpose of 85014, payer coverage scope, and the operational context for administering and billing this routine hematology test.
Billing Code Overview
CPT code 85014 describes a laboratory procedure in which a lab analyst measures the volume percent of red blood cells (hematocrit) in a whole blood specimen. The test quantifies the proportion of blood composed of erythrocytes and is a fundamental component of complete blood count evaluation.
-
Service type: Laboratory diagnostic test
-
Typical site of service: Clinical laboratory or hospital laboratory (specimen collected in outpatient or inpatient settings)
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult or pediatric patient presenting to an ambulatory clinic, hospital inpatient unit, emergency department, or phlebotomy laboratory where a basic complete blood count component is required. A clinician orders a hematocrit to evaluate red blood cell mass for causes such as anemia, polycythemia, hemodilution, dehydration, or monitoring blood loss and fluid status. A phlebotomist collects a whole blood specimen in an appropriate tube (often EDTA) and sends it to the clinical laboratory. A medical laboratory technician or technologist performs the hematocrit determination by automated analyzer or manual centrifugation and records the volume percent of red blood cells. Results are reported in the electronic medical record and interpreted by the ordering clinician to guide fluid management, transfusion decisions, or further diagnostic testing such as hemoglobin, red cell indices, and reticulocyte count.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional component of a laboratory service if applicable (rare for hematocrit which is typically a full lab service). |
59 | Distinct procedural service |