Summary & Overview
CPT 85347: Activated Clotting Time by Physical Activation
CPT code 85347 denotes an activated clotting time test performed by physical activation to determine how long a patient’s blood takes to form a clot. This laboratory procedure is commonly used in perioperative and critical care settings, as well as in monitoring anticoagulation and coagulation disorders. It matters nationally because it supports clinical decision-making in acute care and procedural contexts and is billed regularly by hospital and clinical laboratories.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, a summary of payer coverage patterns and common billing modifiers, and guidance on where to locate relevant policy language. The content outlines benchmarks and common administrative considerations for reporting CPT code 85347 in laboratory service lines. Clinical implications and operational details explain when the test is typically ordered and how it fits into coagulation testing workflows.
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Billing Code Overview
CPT code 85347 describes a laboratory procedure in which a lab analyst measures the time required for clot formation in a patient’s blood sample using a physical activation method. This test assesses clotting function by initiating coagulation through a mechanical or physical activator and recording the clotting time.
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Service type: Laboratory coagulation test (activated clotting time by physical activation)
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Typical site of service: Clinical laboratory or hospital laboratory setting where venous blood samples are processed and analyzed.
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Clinical & Coding Specifications
Clinical Context
A typical patient is a 62-year-old outpatient receiving anticoagulation management or preoperative evaluation who requires assessment of intrinsic pathway clotting function using a physically activated method. The clinician (primary care physician, hematologist, or preoperative clinic provider) orders the assay when monitoring unfractionated heparin therapy, evaluating unexplained bleeding or thrombosis, or assessing coagulation status prior to invasive procedures. A phlebotomy technologist draws a citrate-anticoagulated blood specimen and sends it to the laboratory. In the lab, a medical laboratory scientist or technologist performs the test using a mechanical/physical activation method to initiate clot formation and measures the clotting time. Results are reviewed by a pathologist or laboratory director if abnormal; critical values are relayed to the ordering clinician. Typical sites of service include hospital inpatient laboratories, outpatient hospital laboratories, community hospital clinical labs, and reference laboratory facilities. The service is billed by the performing laboratory under the specified CPT code for this clotting time test using physical activation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional (interpretive) component separate from the technical component. |