Pathology/Lab Coding Alert

Question: What is the difference between codes 85536 and 88313 for iron stain?

Ohio Subscriber

Answer: Code 85536 (Iron stain, peripheral blood) describes a hematology test on a peripheral blood specimen to identify siderotic granules, which are iron deposits in red blood cells that are not incorporated into a hemoglobin molecule.

In contrast, 88313 (Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry) describes a pathology test for bone marrow or other tissues, not blood. Clinicians may order this test and labs may employ a stain such as Perls’ stain (Prussian blue) to assess ferric iron in bone marrow stores to help evaluate conditions such as anemia, iron overload, or myelodysplasia. Unlike 85536, this test involves a physician professional interpretation service.

A CPT^® text note follows code 85536 that states, “for iron stains on bone marrow or other tissues with physician evaluation, use 88313.”