Summary & Overview
CPT 85044: Reticulocyte Count, Manual Microscopic Evaluation
CPT code 85044 designates a manual microscopic evaluation of a stained blood smear to determine the reticulocyte count, an important hematology test that informs assessment of bone marrow function and response to anemia treatment. Nationally, this code represents a common laboratory service used in inpatient, outpatient, and reference laboratory settings to guide clinical management of anemia, hemolysis, and marrow recovery. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise overview of what the code represents, typical sites of service, and the clinical context in which reticulocyte counts are ordered. The publication outlines payer relevance and common billing considerations, and provides clarity on clinical indications tied to reticulocyte assessment. Data not available in the input includes specific associated taxonomies, ICD-10 diagnoses, and related procedure codes. The piece is intended for administrators, laboratory managers, and billing professionals seeking a national-level summary of CPT code 85044 and its role in hematology diagnostics.
Billing Code Overview
CPT code 85044 describes a laboratory procedure in which a trained lab analyst evaluates a stained peripheral blood smear under a microscope to determine the reticulocyte count. This is a manual microscopic review assessing immature red blood cells (reticulocytes) present in the circulation, typically reported as a percentage or absolute count.
-
Service type: Laboratory hematology service involving manual microscopic evaluation
-
Typical site of service: Hospital laboratory, independent clinical laboratory, or hospital outpatient laboratory setting
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A 55-year-old outpatient presents to the hematology clinic with new-onset fatigue and pallor. The treating physician orders a complete blood count (CBC) with peripheral smear and a reticulocyte count to evaluate for active hemolysis versus underproduction anemia. A phlebotomy technician collects a venous blood sample which is sent to the clinical laboratory. A laboratory technologist performs a stained peripheral blood smear and a qualified lab analyst evaluates the slide microscopically to determine the reticulocyte percentage and absolute reticulocyte count, documenting morphology and reticulocytosis or reticulocytopenia. Results are routed to the ordering hematologist, who integrates the reticulocyte count with CBC indices, indirect bilirubin, lactate dehydrogenase, haptoglobin, and direct antiglobulin test to differentiate hemolytic anemia from marrow failure. Typical sites of service include hospital laboratories, independent clinical laboratories, and outpatient clinic laboratories. Service type: Laboratory microscopic analysis of a stained blood smear for reticulocyte count (85044).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation/reporting portion of the test separate from the technical component. |