Pathology/Lab Coding Alert

Question: We received a CSF specimen that we vacuum washed on a cellulose filter to prepare a slide, but also centrifuged and performed filter-transfer to a monolayer slide. Because we performed two filtrations, I-m confused about what code to report. Louisiana Subscriber Answer: When processing a cerebrospinal fluid (CSF) specimen, you should select the most specific code from the non-gynecological cytology sequence as follows: - 88104 -- Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation - 88106 -- - simple filter method with interpretation - 88107 -- - smears and simple filter preparation with interpretation - 88108 -- Cytopathology, concentration technique, smears and interpretation (e.g., Saccomanno technique) - 88112 -- Cytopathology, selective cellular enhancement technique with interpretation (e.g., liquid-based slide preparation method), except cervical or vaginal. In your example, it appears that you performed both a simple filter preparation (88106) and a selective cellular enhancement preparation that involves complex filter transfer techniques (88112). Caution: Correct Coding Initiative (CCI) edits prohibit you from reporting 88106 and 88112 together for the same specimen. Although Medicare clarifies that you cannot separately report any two cytopathology methodologies for the same specimen, even when medically necessary, you should check with your non-Medicare payers to see if they still allow you to bill separately. Clarify filtration terminology: CPT 2007 changed the definitions of 88106 and 88107 to emphasize that the lab method for these codes involves only simple filtration, not the more complex filter transfer technique used in monolayer preparations earning 88112.