85060

annettebec

Networker
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Swartz Creek, MI
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85060 is only covered as an inpatient for Medicare. Is anyone charging out commercial insurances for this procedure and if you are - are you getting paid? Thanks AB
 

skumar

Contributor
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What are the requirements for reporting CPT 85060 for a Peripheral Blood Smear?

1. There should be a written laboratory policy, approved by the hospital, stating that when the WBC exceeds a certain threshold, a pathologist will review the slide and issue a written report.

2. In addition to the notation in the chart, generate a separate laboratory report for the medical record.

3. Both the chart notation and the report must be authenticated, that is, signed and dated.

Remember, Medicare will only pay for 85060 for hospital inpatients. There is no modifier to add to receive payment for outpatient, nor can you report CPT code 80500 (Clinical consultation code) instead of code 85060.

We are adjusting the payment for 85060 if done in Outpatient for Medicare.

Hope this helps.

Thanks
Suresh
 
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