HMO Blue® Texas Outpatient Clinical Reference Lab Services

Effective 7/01/2004 - 9/30/2005

For physicians and professional providers located in the following counties, the lab services that will be reimbursed on a fee-for-service basis if performed in the physician's office for HMO Blue Texas members are included on the STAT Lab Services list that follows below.

Austin
Johnson
Atascosa
Kaufman
Bell
Lavaca
Bexar
Leon
Brazoria
Liberty
Brazos
Madison
Calhoun
Matagorda
Chambers
McLennan
Collin
Medina
Comal
Montague
Cooke
Montgomery
Dallas
Nueces
Denton
Orange
Ellis
Parker
Fannin
Polk
Fort Bend
Robertson
Galveston
Rockwall
Gonzales
San Jacinto
Grayson
Somervell
Grimes
Tarrant
Guadalupe
Trinity
Hardin
Victoria
Harris
Walker
Hood
Waller
Houston
Washington
Hunt
Wharton
Jackson
Wilson
Jefferson
Wise
Jim Wells
 

Note: HMO Blue Texas physicians and professional providers who are contracted/affiliated with a capitated IPA/Medical Group must contact the IPA/Medical Group regarding outpatient laboratory services.

   

STAT Lab Services - Effective 7/01/2004 to 9/30/2005

Test Description

CPT Code

Basic metabolic panel

80048

Electrolyte panel

80051

Urinalysis, dipstick

81000

Urinalysis, with microscopy, automated

81001

Urinalysis, without microscopy, non-automated

81002

Urinalysis, without microscopy, automated

81003

Urinalysis, bacteriuria screen, except by culture or dipstick

81007

Pregnancy test, urine

81025

Stool for occult blood (Hemoccult)

82270

Glucose, blood, quantitative

82947

Glucose, blood, reagent strip

82948

Glucose, blood, monitoring device

82962

Bleeding time

85002

Blood count, differential WBC, automated

85004

Blood count, smear, WBC differential, manual

85007

Blood count, smear, no WBC differential

85008

Blood count, spun microhematocrit

85013

Blood count, hematocrit

85014

Blood count, hemoglobin

85018

Blood count, complete CBC & WBC differential, automated

85025

Blood count, complete CBC, automated

85027

Blood count, manual, each

85032

Blood count, platelet, automated

85049

Coagulation time, Lee and White

85345

Coagulation time, Lee and White, activated

85347

Coagulation time, Lee and White, other methods

85348

Prothrombin time

85610

Heterophile antibody screen for mononucleosis

86308

Wet mount for infectious agents

87210

Tissue exam by KOH slide

87220

Influenza

87400

Strep screening, qualitative

87430

Strep screening, rapid

87880

Note: Venipunctures will be reimbursed when performed in the physician’s office.