Pathology/Lab Coding Alert

Question: The lab received a sperm specimen and a request for a Toluidine blue assay for DNA integrity. What is this test for, and how should we code it?

Maine Subscriber

Answer: Although not commonly used, the Toluidine blue (TB) assay is a simple stain to evaluate sperm for fragmented DNA and/or abnormal chromatin structure. A high percentage of TB-positive stained sperm may indicate male infertility problems.

The TB sperm assay does not currently have a proven clinical utility, and it is not part of the standard semen parameters measured for infertility analysis. As such, there is not a distinct CPT® code for the test. 

One possibility is to report the test using 88313 (Special stain including interpretation and report; Group II, all other [e.g., iron, trichrome], except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry). Alternately, you might report the test using 89398 (Unlisted reproductive medicine laboratory procedure). 

Do this: You should contact your payer for coverage and billing instruction for this test.