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CPT 87205

Smear gram stain

CPT 87205 Pathology and Laboratory

Description

Smear gram stain

Documentation Requirements

  • Document clinical indications and clear medical necessity supporting the encounter or procedure.
  • Ensure complete provider signatures, credentials, date, and specific place of service (POS).
  • Verify documentation strictly supports code specificity to prevent downcoding or claim denials.

Billing & Coding Tips

  • Verify current payer fee schedules, NCCI edits, and Medically Unlikely Edits (MUEs).
  • Append correct modifiers (e.g., 25, 59, 26, TC) where distinct procedural services or components apply.
  • Confirm pre-authorization rules with Medicare, Medicaid, and commercial plans before submission.

Related Codes

87206 87207 87209 87210 87220 87230 87250 87252 87253 87254 87255 87260 87265 87267 87269

Quantum Health Services provides full-cycle revenue cycle management and medical billing services nationwide. This code reference is for educational purposes; always verify official payer policies. CPT© descriptors require proper AMA licensing.