Pathology/Lab Coding Alert

Question: Our lab started receiving specimens from an otolaryngologist client for HPV testing. We currently code HPV tests from gynecological specimens using 87621 -- can we use the same code for non-gyn specimens?

Connecticut Subscriber

Answer: You can report 87621 (Infectious agent detection by nucleic acid (DNA or RNA); papillomavirus, human, amplified probe technique) for an HPV test from any source -- provided amplified probe technique is the method your lab uses for the test.

You should distinguish HPV tests on the basis of the lab method, not based on the specimen source. CPT® provides other codes that describe HPV tests using different methods, such as 87620 (Infectious agent detection by nucleic acid (DNA or RNA); papillomavirus, human, direct probe technique). If your lab tests for HPV using in situ hybridization (IHS), you should report one of the following codes:

• 88365 -- In situ hybridization (e.g., FISH), each probe
• 88367 -- Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) each probe; using computer assisted technology
• 88368 -- ... manual.

Watch professional fee: Unlike 87620-87621, the ISH codes (88365-88368) include a technical and professional component. If you bill the codes globally, you'll receive payment for both components. If your lab performs only the technical work, you should bill the appropriate code with modifier TC (Technical component). The pathologist who performs the interpretation would then separately bill the same code with modifier 26 (Professional component).