Pathology/Lab Coding Alert

Question: We use a May-Grunwald-Giemsa stain on bone marrow specimens. Since the stain is not for microorganisms, should we use 88313 to report the work?

Colorado Subscriber

Answer: No, you should not report +88313 (Special stains [list separately in addition to code for primary service]; Group II, all other [e.g., iron, trichrome], except immunocytochemistry and immunoperoxidase stains, each) for the May-Grunwald-Giemsa stain for bone marrow.

You are correct that you should use +88313 for special stains for "other" than microorganisms. CPT reserves +88312 (- Group I for microorganisms [e.g., Gridley, acid fast, methenamine silver], each) to describe special stains performed to help detect microorganisms.

Here's the caveat: May-Grunwald-Giemsa is not a "special stain" for bone marrow specimens. For bone marrow smears, the Wright stain or the May-Grunwald-Giemsa stain is the default stain to enhance cytologic detail for routine morphologic specimen evaluation.

Just as you should not report a special stain code for hematoxylin and eosin (H&E) stain used as the basic stain to prepare many tissue slides, you should not report a special stain code for the basic stain you use on the bone marrow smear.

Do this: Include the May-Grunwald-Giemsa stain in the basic charge for the bone marrow aspiration smear evaluation -- 85097 (Bone marrow, smear interpretation).

You should report a special stain code only for a bone marrow specimen if you perform an additional stain for a specific purpose, such as myeloperoxidase to help characterize myeloid leukemia

Reader Questions and You Be the Coder were prepared with the assistance of R.M. Stainton Jr., MD, president of Doctors- Anatomic Pathology Services in Jonesboro, Ark.