Summary & Overview
CPT 85536: Iron Stain for Siderotic Granules on Peripheral Blood Smear
CPT code 85536 represents a technical laboratory test that uses an iron stain on peripheral blood smears to identify siderotic granules (iron deposits) within red blood cells. This hematology diagnostic procedure assists clinicians in evaluating disorders of iron metabolism, hemoglobinopathy workups, and certain anemias where visualization of intracellular iron is clinically relevant. Nationally, accurate coding and reporting of 85536 support laboratory quality metrics, clinical decision-making, and appropriate reimbursement for specialized staining techniques.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns, billing benchmarks, and coding considerations where available. It also situates 85536 in clinical context for laboratory and hospital settings.
Readers will find a concise explanation of what CPT code 85536 denotes, typical sites of service, and the clinical rationale for the test. The report summarizes benchmark measures and payer considerations relevant to laboratories and health systems, and highlights any notable policy updates or coding guidance when present. Data not available in the input is identified as such in specific sections.
Billing Code Overview
CPT code 85536 describes a laboratory test that detects iron deposits (siderotic granules) in red blood cells using an iron stain applied to peripheral blood smears. The service is a technical laboratory procedure performed by a clinical laboratory analyst or technologist to identify intracellular iron in erythrocytes.
Service type: Technical laboratory test
Typical site of service: Clinical laboratory or hospital laboratory performing peripheral blood smear analysis
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with a history of chronic alcohol use and iron overload presents with persistent fatigue and mild jaundice. The hematology service orders a peripheral blood smear with iron stain to evaluate for sideroblastic changes and the presence of siderotic granules within red blood cells (Pappenheimer bodies). A phlebotomy or outpatient lab draw is performed; a laboratory technician prepares the peripheral blood smear, applies an iron-specific histochemical stain (e.g., Prussian blue), and a laboratory analyst performs the microscopic technical evaluation to identify and report iron deposits in erythrocytes. The result is used by the ordering clinician to differentiate causes of anemia (e.g., sideroblastic anemia, iron-loading states, post-transfusion changes) and to guide further diagnostic testing such as bone marrow biopsy or iron studies.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the professional (interpretation) portion if separated from the technical component |
TC | Technical component | When billing only the laboratory technical component (stain and slide preparation) without interpretation |