Summary & Overview
CPT 85046: Automated Reticulocyte Count with Cellular Parameter Evaluation
Headline: CPT code 85046: Automated Reticulocyte Count and Cellular Parameter Evaluation
Lead: CPT code 85046 identifies an automated hematology test that measures reticulocyte counts and evaluates one or more analyzer-derived cellular parameters. The code is central to diagnosing and monitoring disorders of red blood cell production and is widely used across clinical laboratories nationwide.
CPT code 85046 represents an automated reticulocyte count performed by a laboratory analyst using a hematology analyzer to quantify reticulocytes and report additional cellular metrics. This service matters nationally because reticulocyte measurements inform diagnoses such as anemia etiology, bone marrow response to therapy, and monitoring of hematologic treatments.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical role, payer coverage context, and practical benchmarks for lab service classification. The publication summarizes coding definitions, typical sites of service, and the clinical scenarios that commonly generate use of this code.
What readers will learn: concise clinical context for ordering and interpreting reticulocyte testing; how CPT code 85046 is defined and applied in laboratory settings; which major payers include coverage considerations for automated reticulocyte testing; and where to look for related procedural and billing guidance.
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Billing Code Overview
CPT code 85046 describes a laboratory procedure in which a lab analyst uses an automated hematology analyzer to determine the reticulocyte count and evaluate one or more cellular parameters. This test quantifies immature red blood cells (reticulocytes) and reports associated analyzer-derived metrics that support assessment of erythropoiesis.
Service Type: Automated hematology reticulocyte count with cellular parameter evaluation
Typical Site of Service: Clinical laboratory or hospital laboratory
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Clinical & Coding Specifications
Clinical Context
A 45-year-old outpatient with a history of chemotherapy for non-Hodgkin lymphoma presents for routine laboratory monitoring. The clinician orders a reticulocyte count to assess marrow response following recent cytotoxic therapy and to evaluate anemia management. A phlebotomy technician draws a peripheral blood specimen at an ambulatory clinic laboratory. The specimen is processed by the hospital or independent laboratory technologist who runs an automated hematology analyzer that reports the reticulocyte percentage/absolute count and additional cellular parameters (for example, mean reticulocyte hemoglobin content). Results are transmitted to the ordering provider; abnormal results may prompt correlation with complete blood count, peripheral smear review, iron studies, erythropoietin level, or hematology consultation. Typical site of service is an outpatient laboratory, hospital clinical laboratory, or physician office lab. Service type is an automated hematology laboratory test (reticulocyte count) performed by a clinical laboratory scientist or technologist using automated instrumentation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting only the professional interpretation component separate from the technical laboratory component if applicable for consultative interpretation of results. |