Pathology/Lab Avg. $8

CPT 85027: Complete Blood Count (CBC), Automated

Complete blood count (CBC), automated (hemoglobin, hematocrit, RBC, WBC, platelet count). Does not include differential. A basic hematology panel for screening and monitoring blood disorders.

Why CPT 85027 Claims Get Denied

Claims billed under CPT 85027 are frequently denied or downcoded for the following reasons. Understanding these patterns helps your practice reduce denial rates and recover revenue faster.

Duplicate with CBC with differential (85025) on same date

Frequency exceeds medical necessity guidelines

Diagnosis code does not support the test

Bundled with other hematology panel

Billing Tips for CPT 85027

If a differential is also performed, bill 85025 instead (CBC with automated differential). Do not bill 85027 and 85025 on the same date. Link to appropriate diagnosis such as anemia, infection, or pre-surgical screening.

Documentation Requirements

To support a clean claim for CPT 85027, your clinical documentation should include:

Provider order

Clinical indication for the test

Results documented in the medical record

Interpretation and follow-up plan

Common Modifiers for CPT 85027

Modifier QW

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