PCP Office Lab List - covered list

85032 Blood count; manual cell count (erythrocyte leukocyte or platelet) each

85049 Blood count; platelet automated

85610 Prothrombin time

85651 Sedimentation rate, erythrocyte; non-automated

85730 Thromboplastin time, partial (PTT); plasma or whole blood

86308 Heterophile antbodies; screening

86403  Particle agglutination; screen, each antibody

86580 Skin test; tuberculosis, intradermal

86710 Antibody; influenza virus

87070 Culture, bacterial; any other source except urine, blood or stool, with isolation and presumptive identification of isolates

87081 Culture, presumptive, pathogenic organisms, screening only

87086 Culture, bacterial; quantitative colony count, urine

87088 Culture, bacterial; with isolation and presumptive identification of isolates, urine

87177 Ova and parasites, direct smears, concentration and identification

87205 Smear, primary source with interpretation, Gram or Giemsa stain for bacteria, fungi, or cell types

87210 Smear, primary source with interpretation; wet mount for infectious agents (e.g., saline, India ink, KOH preps)

87220 Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (e.g., scabies)

87400 Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple step method; Influenza, A or B, each

87430 Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple step method; Streptococcus, group A

87480 Infectious agent detection by nucleic acid (DNA or RNA); candida species, direct probe technique

87510 Infectious agent detection by nucleic acid (DNA or RNA); gardnerella vaginalis, direct probe

technique

87660 Infectious agent detection by nucleic acid (DNA or RNA); trichomonas vaginalis, direct probe technique

87802 Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus, group B

87803 Infectious agent antigen detection by immunoassay with direct optical observation; Clostridium difficile toxin A

87804 Infectious agent antigen detection by immunoassay with direct optical observation; Influenza

87807  Infectious agent antigen detection by immunoassay with direct optical observation; respiratory syncytial virus

87880 Infectious agent detection by immunoassay with direct optical observation; Streptococcus, group A

88738 Hemoglobin (Hgb), quantitative, trancutaneous

89055 Leukocyte count fecal

G0306 Complete CBC, automated (HgB, HCT, RBC, WBC, without platelet count) and automated WBC differential count

G0307 Complete (CBC), automated (HgB, HCT, RBC, WBC, without platelet count)

00111 Wet mounts, including preparation of vaginal, cervical or skin specimens

S3620 Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g. galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d, phenylanine (PKU); and thyroxine, total