Summary & Overview
CPT 85045: Automated Reticulocyte Count
CPT code 85045 reports an automated hematology analyzer determination of the reticulocyte count, a common laboratory measure of bone marrow activity and red blood cell production. Nationally, reticulocyte testing is integral to diagnosing and monitoring anemia, evaluating marrow recovery after therapy, and guiding transfusion and treatment decisions. Accurate coding of 85045 supports appropriate laboratory payment and clinical data capture.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for reticulocyte testing, typical sites of service, common billing modifiers used with laboratory procedures, and how 85045 relates to laboratory service lines. The publication also summarizes benchmarks and policy considerations that affect reimbursement and documentation for automated reticulocyte counts, and highlights practical coding guidance for inclusion on laboratory service lines. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 85045 describes a laboratory procedure in which a lab analyst uses an automated hematology analyzer to determine the reticulocyte count. This test quantifies immature red blood cells to assess bone marrow response and monitor anemia or response to therapy.
Service Type: Laboratory / Pathology
Typical Site of Service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient with a history of recent chemotherapy presents for routine laboratory monitoring. The treating oncologist orders a reticulocyte count to assess bone marrow response following cytotoxic treatment and to evaluate anemia recovery. A blood specimen is collected in an EDTA tube in the outpatient phlebotomy area or hospital laboratory; the specimen is routed to the hematology laboratory. A clinical laboratory scientist or technologist prepares the sample and runs it on an automated hematology analyzer calibrated for reticulocyte enumeration. Results are reviewed by the laboratory supervisor and finalized in the electronic laboratory system; findings are communicated to the ordering provider for interpretation and potential therapy adjustment.
Typical site of service: Hospital laboratory or independent clinical laboratory; outpatient phlebotomy or ambulatory clinic collection point.
Service type: Automated hematology laboratory test (reticulocyte count) performed by laboratory personnel using an automated analyzer.
Typical patient scenario: Monitoring marrow recovery after chemotherapy or bone marrow suppression, evaluation of anemia (differentiating hypoproliferative versus hemolytic processes), or follow-up after treatment for iron deficiency or hemolytic anemia.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component if applicable and separately reportable. |