Pathology/Lab Coding Alert

Question: The pathology report for a colon biopsy states, "rapid imprints and frozen section evaluated during surgery." The pathologist wants to bill 88331, 88333, and 88305. What is a "rapid imprint," and is this coding correct?

Maine Subscriber

Answer: The term "rapid imprint" refers to a cytology specimen that the pathologist acquires by touching or squashing a slide against a tissue specimen. Other names for the same specimen type includes "touch prep," "touch imprint," "squash prep," etc.

Because you state that the pathologist performs the touch prep and frozen section during surgery, you should report the following codes:

• 88331 -- Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen

• 88334 -- ... cytologic examination (e.g., touch prep, squash prep), each additional site.

Your pathologist was almost correct with 88331 and 88333 (... cytologic examination [e.g., touch prep, squash prep], initial site), but a CPT note following 88334 states "for intraoperative consultation on a specimen requiring both frozen section and cytologic evaluation, use 88331 and 88334." In other words, you should consider a touch prep as an additional site if the pathologist performs it with a frozen section.

Caution: CMS has created a Correct Coding Initiative (CCI) edit pair for 88331 and 88334 that you cannot override in cases that involve evaluations from the same site. Because your pathology report doesn't document different sites, you can only report the frozen section (88331).

For the pathologist's examination of the colon biopsy specimen, you should bill 88305 (Level IV -- Surgical pathology, gross and microscopic examination, colon, biopsy).