Pathology/Lab Coding Alert

Question: Our pathologist went to the surgical suite and performed an FNA adequacy check using a Diff Quik stain. Can we bill 88172 and 88313?

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Answer: No, you should not bill both codes you mention for the service you describe.

For the pathologist’s adequacy check of a fine needle aspiration (FNA) specimen, you’re correct to list 88172 (Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site). 

It appears that the case involves a single evaluation episode, but if not, you might be able to report another code. If the pathologist evaluated the FNA, reported to the surgeon that the specimen was inadequate for diagnosis, and the surgeon withdrew a new aspirate from the same site that the pathologist then evaluated for adequacy, you would also report +88177 (Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site [List separately in addition to code for primary procedure]).

Not special. Because Diff Quik is a standard stain for cytopathology specimens such as FNA, you should not report the special stain code that you mentioned: 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).