Pathology/Lab Coding Alert

Question: When our pathologists perform a combined Alcian Blue/PAS stain for esophagus biopsy, how should we code the service? They usually use the stain to diagnose Barrett's esophagus. But the periodic acid schiff (PAS) also shows fungus, if present. Which code is correct -- 88312 or 88313? Should we report one or two units of service?

Mississippi Subscriber 

Answer: Because the pathologists performed one stain -- albeit a combined stain -- you should report only one unit of service. And although the PAS would identify any fungus present, the pathologist does not perform the stain on an esophagus biopsy to identify micro-organisms. That's why you shouldn't report this stain as +88312 (Special stains [list separately in addition to code for primary service]; Group I for micro-organisms [e.g., Gridley, acid fast, methenamine silver], each).

The primary purpose of the Alcian Blue/PAS stain for the esophagus biopsy is to identify goblet cells, which are diagnostic for Barrett's esophagus. You should report the service as +88313 (...; Group II, all other [e.g., iron, trichrome], except immunocytochemistry and immunoperoxidase stains, each).