Pathology/Lab Coding Alert

California Subscriber

Answer: The number of days between the original case and the 88363 (Examination and selection of retrieved archival [i.e., previously diagnosed] tissue[s] for molecular analysis [e.g., KRAS mutational analysis]) service is not the key factor in determining if it's appropriate to use the code, which CPT added in 2011.

Definitions differ: Don't confuse CPT's use of the term "archival tissue(s)" with Medicare's definition of an "archived specimen" (older than 30 days) -- the two terms are not the same.

For purposes of CPT code 88363, the case is "archival" when the pathologist has released the case report and sent the slides/ tissues to be stored. That means you should not use 88363 if the pathologist or treating physician decides to prep tissue for a molecular test such as KRAS before the pathologist completes the primary case (such as 88307, Level V -- Surgical pathology, gross and microscopic examination, ...) and signs it out.

In your specific question, if the pathologist issued the report (signed out the case) for the original pathology exam on 1-6- 11, you could legitimately bill 88363 on 1-10-11 (assuming the pathologist performs the service.)