Pathology/Lab Coding Alert

Question:  Is it appropriate to bill 88177 with modifier 59 when the pathologist performs multiple “adequacy checks” for FNA?

Texas Subscriber

Answer:  No, you should not use modifier 59 (Distinct procedural service) if your pathologist perform multiple “adequacy checks” for fine needle aspiration (FNA) specimens.

The correct way to use the FNA adequacy check codes is to report 88172 (Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site) for the first immediate adequacy check from a single site.

For any subsequent evaluation episodes from the same site, you should use the add-on code +81777 (… immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site [List separately in addition to code for primary procedure]). List one unit of +88177 for each additional immediate cytohistologic study from the same site.

You can report multiple units of +88177 without a modifier because it is an add-on code. CPT® instructs you to “use 1 unit of 88177 for each additional evaluation episode.”