Oncology & Hematology Coding Alert

Question: We have an on-site lab and use the Vysis FISH probe kit to aid in monitoring bladder cancer. Can we code the ThinPrep slide in addition to the FISH test 88368?


Texas Subscriber

Answer: Labs may carry out the fluorescence in situ hybridization (FISH) test for identifying chromosomal abnormalities in urine cytology on fresh urine specimens or liquid-based cytology slides. If you perform the FISH on a fresh urine specimen, you should not code for a thin-layer slide preparation. 

But if you prepare the liquid cytology slide using a system such as CyTyc ThinPrep and then use the UroVysion FISH probes on that specimen, you can bill for both procedures.

The correct code for a urine ThinPrep is 88112 (Cytopathology, selective cellular enhancement technique with interpretation [e.g., liquid-based slide preparation method], except cervical or vaginal). 

The Vysis FISH kit for bladder cancer detection uses four-color interphase DNA probes, so the proper coding for the test is four units of 88368 (Morphometric analysis, in situ hybridization [quantitative or semi-quantitative], each probe; manual).

You may bill both 88112 and 88368 x 4 together if you perform both tests on the urine specimen.

Remember: If you obtain the specimen and send it to an outside lab, the lab will bill for the test.

The answers for You Be the Coder and Reader Questions were reviewed by Cindy C. Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Powder Springs, Ga., and president of the American Academy of Professional Coders National Advisory Board.