Summary & Overview
CPT 85445: Heinz Body Preparation and Evaluation
CPT code 85445 denotes a specialized hematology laboratory procedure that evaluates a blood specimen, after treatment with acetyl phenylhydrazine, for the presence of Heinz bodies. This test identifies oxidative damage to red blood cells and supports the diagnosis of hemolytic disorders related to drugs, toxins, or inherited red cell vulnerabilities. It is an established laboratory assay with implications for clinical management and laboratory workflow.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise benchmarks on coverage patterns, typical sites of service, and clinical context for ordering and interpreting the test. The report summarizes coding considerations, common modifiers for laboratory services, and how this assay fits into diagnostic pathways for hemolysis and red cell disorders.
The publication provides practical reference material for laboratorians, billing teams, and clinicians: an overview of the procedure, where it is commonly performed, payer scope, and the clinical scenarios that prompt testing. Data not available in the input are noted where relevant.
Billing Code Overview
CPT code 85445 describes a laboratory evaluation in which a blood specimen is treated with acetyl phenylhydrazine and examined for Heinz bodies, which are intracellular inclusions indicating oxidative damage to red blood cells. This test assesses red blood cell integrity and can aid in identifying hemolytic processes caused by oxidant drugs, toxins, or inherited vulnerabilities.
Service Type: Specialized hematology laboratory test
Typical Site of Service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with unexplained hemolytic anemia presents to a hospital laboratory after referral from the hematology clinic. The clinician orders specialized testing to evaluate red blood cell structural integrity. The laboratory collects a peripheral blood sample; the technologist treats an aliquot with acetyl phenylhydrazine and examines the specimen microscopically for the presence of Heinz bodies. The result helps differentiate oxidative hemolysis (for example, G6PD deficiency or drug-induced oxidative injury) from other causes of hemolysis and guides the hematologist's diagnostic workup and management decisions. Typical site of service is an outpatient clinical laboratory or hospital laboratory (clinical pathology/hematology section). The service is billed by the performing laboratory or pathologist, who documents specimen receipt, reagent administration, incubation, microscopic evaluation, and results in the laboratory information system.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when a physician/pathologist bills only the professional interpretation component of the test |
TC | Technical component |