Summary & Overview
CPT 85348: Unspecified Coagulation Time Assay
CPT code 85348 denotes a laboratory coagulation time assay performed by a lab analyst using a method that is not otherwise specified by more specific CPT codes. This general coagulation test can be used when standard, named assays are not appropriate or available; it matters nationally because coagulation testing underpins diagnosis and management of bleeding and thrombotic disorders across inpatient and outpatient settings. Key payers covered in this review include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare.
Readers will find a concise explanation of what the code represents and where it is typically performed. The publication outlines payer coverage patterns and common billing modifiers (when available), clinical contexts in which an unspecified coagulation time assay may be used, and how this code relates to more specific coagulation procedure codes. It also summarizes billing and claim considerations relevant to laboratories and hospital billing departments, and notes where input data was not provided. This national-level brief is intended to help billing managers, laboratory directors, and policy analysts quickly understand the clinical purpose and administrative considerations associated with CPT code 85348.
Billing Code Overview
CPT code 85348 describes a laboratory test in which a lab analyst measures the time it takes for a clot to form in a patient’s blood sample using a method not represented by a more specific code. This represents a general coagulation time assay performed when existing, more specific coagulation procedure codes do not apply.
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Service type: Laboratory coagulation assay
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Typical site of service: Clinical laboratory or hospital lab setting
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a history of unexplained bleeding and bruising presents to the outpatient hematology clinic. The provider orders a laboratory evaluation of hemostasis to determine clot formation time using a method not represented by a more specific code. A phlebotomist collects a citrated plasma specimen and sends it to the core laboratory. A clinical laboratory scientist performs a specialized clot-timing assay (not a standard PT/INR or aPTT method) to evaluate intrinsic or extrinsic pathway function or to evaluate a novel or modified reagent/protocol. Results are reviewed by the laboratory director and communicated to the ordering hematologist, who integrates findings with clinical exam and other coagulation studies to determine bleeding risk and guide further management. Typical workflow includes specimen receipt, processing, performance of the non-standard clotting assay, recording of clot times, quality control checks, and result reporting in the electronic health record.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component if the laboratory separates technical and professional components. |
TC | Technical component |