Pathology/Lab Coding Alert

Question: Our lab sometimes receives orders from a client for a "pre-procedure workup" involving tests 85025, 85610, and 85730. We need a diagnosis supporting the tests -- what do you recommend?Mississippi SubscriberAnswer: You have to get the diagnosis from the ordering physician, either in the form of ICD-9 code(s) or a narrative diagnosis stating the reason for the test. You mentioned the following codes for the tests: 85025 -- Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count 85610 -- Prothrombin time 85730 -- Thromboplastin time, partial (PTT); plasma or whole blood. Payers generally consider testing prior to any medical intervention associated with a risk of bleeding and thrombosis (other than thrombolytic therapy) medically necessary only under certain circumstances. These can include signs or symptoms of a bleeding or thrombolytic abnormality; or personal history of bleeding, thrombosis, or a condition associated with coagulopathy. But you need [...]