Pathology/Lab Coding Alert

Question: Our pathologist sometimes examines a sputum cytology cytospin and cell block. We report the 88305 for the cell block and 88160 for the cytospin, but Medicare denies the 88160. How can we get paid for both services?
   
Tennessee Subscriber

Answer: Although sputum is an appropriate specimen for 88160 (Cytopathology, smears, any other source; screening and interpretation), you should report your cytospin as 88108 (Cytopathology, concentration technique, smears and interpretation [e.g., Saccomanno technique]) because you use a concentration technique. You are correct to report the cell block as 88305 (Level IV - Surgical pathology, gross and microscopic examination, cell block, any source).

Medicare's National Correct Coding Initiative edits bundle 88160 with 88305, which is why you would receive denials when you report these two services together. By correctly reporting your sputum concentration using 88108, you should get paid for both the cytospin and the cell block, because NCCI does not bundle 88108 and 88305.