Flowcytometry/ tc 1 marker
CPT code 88184 is for a specialized lab test called flow cytometry that analyzes cells using one specific marker or identifier. This test helps doctors identify cell types and characteristics important for diagnosing blood disorders, cancers, and immune system conditions.
This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
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Billing tips
Verify the exact number of markers used before coding; 88184 is for ONE marker only, while 88185 covers 2-8 markers and 88186 covers 9-15 markers
Impact: Incorrect marker count coding can result in underpayment of $50-150 per test or denials for overbilling
Always bill the appropriate number of units based on separately analyzed specimens, not the number of markers per specimen
Impact: Each specimen analyzed with one marker warrants one unit of 88184, ensuring full $75.69 reimbursement per specimen
Include the specific marker/antibody used in the procedure description or medical record to support medical necessity
Impact: Prevents medical necessity denials and supports audit defense, protecting the full $75.69 payment
Link to specific diagnosis codes that justify the flow cytometry testing, such as D72.9 for white blood cell disorders or C95.90 for leukemia
Impact: Proper ICD-10 linkage reduces denial rates by 15-25% for flow cytometry claims
Do not separately bill 88184 when comprehensive multi-marker panels (88185 or 88186) are performed on the same specimen
Impact: Prevents unbundling denials and potential audits; bill only the higher-level code capturing all markers used
Confirm CLIA certification status and ensure laboratory meets high-complexity testing requirements before billing
Impact: Billing without proper certification can result in 100% claim denial and potential Medicare exclusion
Common denials
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