Question:

What code would I report if the physician has ordered only a CBC with no mention of a differential?

Answer:

Understand that billing for a CBC with or without a differential has historically been the focus of OIG audits and is again being identified as an issue in post-payment reviews. If the physician has ordered only a CBC with no mention of a differential, the correct code is 85027. Understand that even if a lab has a policy in place to always perform an automated differential with a CBC regardless of what is included in the request/order, the laboratory may bill only for what is ordered in the patient’s medical record.

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