CPT® Code 85652 is used to report automated erythrocyte sedimentation rate (ESR) testing, a laboratory assay that measures how quickly red blood cells settle in a test tube over a specified period. ESR is a non-specific marker of inflammation and is commonly used to support the evaluation of inflammatory, autoimmune, infectious, and rheumatologic conditions.
This code represents the automated laboratory test itself, not specimen collection, interpretation, or evaluation and management services, which may be reported separately when appropriate.
Key Facts About CPT® 85652
- Service type: Laboratory blood test
- Provider type: Physicians, laboratories, and qualified healthcare professionals
- Medical services included: Yes—automated ESR measurement
- Specimen type: Whole blood
- Test purpose: Inflammation assessment
- Common clinical indications:
- Suspected inflammatory or autoimmune disorders
- Rheumatologic conditions such as rheumatoid arthritis or polymyalgia rheumatica
- Chronic infection evaluation
- Monitoring disease activity or treatment response
When to Use CPT® 85652
CPT 85652 is appropriate when:
- ESR testing is ordered to evaluate systemic inflammation
- Providers need a non-specific marker to support clinical assessment
- Monitoring inflammatory conditions over time
- Assessing response to treatment in chronic inflammatory disease
Examples:
- Ordering ESR testing for a patient with suspected temporal arteritis
- Monitoring disease activity in rheumatoid arthritis
- Evaluating unexplained fever or systemic symptoms
Documentation Requirements
To support CPT 85652 billing, documentation should include:
- Patient identifiers and date of service
- Clinical indication for ESR testing
- Specimen source
- Test performed (automated erythrocyte sedimentation rate)
- Test result and date reported
- Ordering provider information
Accurate documentation ensures compliance, appropriate reimbursement, and continuity of care.
Reimbursement and Coding Considerations
- CPT 85652 is generally covered when medically necessary
- Appropriate diagnosis coding is required to support inflammatory indications
- Specimen collection may be billed separately, if allowed by payer
- Frequency limitations may apply depending on payer policy
- Should not be used for routine screening unless payer guidelines permit
Always verify payer-specific laboratory testing requirements before billing.
How OptiMantra Supports ESR Testing
OptiMantra’s integrated EMR and practice management system streamlines documentation and billing for CPT 85652:
With OptiMantra, providers can:
- Order and document ESR tests directly within the patient chart
- Track inflammatory markers longitudinally
- Link ESR results to treatment plans and diagnoses
- Generate audit-ready laboratory billing codes
- Maintain complete lab histories for clinical decision-making
By centralizing lab workflows, OptiMantra helps practices improve efficiency, support compliance, and optimize reimbursement.
Try OptiMantra for free here!
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