Pathology/Lab Coding Alert

Question: Our lab performed direct smear and simple filter prep for a bladder washing specimen, but we received a denial for 88107. What could be the reason for the denial?

Texas Subscriber

Answer: You claim probably denied because CPT^® deleted 88107 (Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears and simple filter preparation with interpretation) in 2012.

Instead, you should “use 88104 (Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation), 88106(…simple filter method with interpretation)” according to CPT^® instruction.

Problem: CPT^® includes a text note that states, “Do not report 88106 in conjunction with 88104,” so you can’t claim both codes for your service. Also, Medciare’s Correct Coding Initiative (CCI) Policy Manual states, “A cytopathology preparation from a fluid, washing, or brushing should be reported using one code from the CPT code range 88104-88112.” 

Do this: You should select just one code — 88104 or 88106 — if you prepare direct smears and simple filter smears from the same specimen. You can select the code with the higher fee — 88106.