Pathology/Lab Coding Alert

Question: I-ve been told that I should code BAL specimens as 88112, but I-ve always used 88108 -- which is correct?

Texas Subscriber

Answer: The correct code for bronchoalveolar lavage (BAL) depends on the lab method you use to process the material. This is true for any non-gynecological cytology specimen that you can classify as -fluids, washings or brushings- (except FNA).

The possible codes for a BAL specimen, depending on how you process it, are:

- 88104 -- Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation

- 88106 -- - simple filter method with interpretation

- 88107 -- - smears and simple filter preparation with interpretation

- 88108 -- Cytopathology, concentration technique, smears and interpretation (e.g., Saccomanno technique)

- 88112 --Cytopathology, selective cellular enhancement technique with interpretation (e.g., liquid based slide preparation method), except cervical or vaginal.

If you-ve always processed BAL specimens using a concentration technique, such as cytospin, you are correct to report 88108. But if you simply prepare a direct smear, you should report 88104. If the lab uses thin-layer preparation to enhance the cellular material for examination, report 88112.

Tip: Although using the method to select the proper code for non-gyn specimens is generally true, fine needle aspiration (FNA) is the one exception. You should use the FNA codes 88172 (Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy of specimen[s]) and/or 88173 (- interpretation and report) for cellular material extracted by FNA, regardless of which method(s) the lab uses to process the material.