Pathology/Lab Coding Alert

Question: When our pathologist performs three PAS stains, three Masson stains, and one Jones stain on a kidney biopsy specimen, how should we report the service -- 88313 x 3 or 88313 x 7?

Nebraska Subscriber

Answer: You are correct in your code selection for each of these stains: +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).

The +88313 descriptor indicates that you should code once per stain. The definition specifies -each.-

But the real question is this: Each individual stain on what -- on a single slide, or on all the slides from a single block, or on all the slides from a single specimen?

The instructions direct you to -list separately in addition to the code for primary service.- That means you should report each separate stain you perform on each -primary service.- When the primary service is a surgical pathology exam like 88305, we know that the specimen is the unit of service.

The College of American Pathologists (CAP) has stated this interpretation in -Cracking the Code,- CAP Today, July 1999: -Special stain codes (88312 to 88314) are used per stain, per specimen regardless of the number of slides stained.-

Because your example is a single kidney biopsy specimen with three PAS stains, three Masson stains, and one Jones stain, you should report one code for each of the three unique stains used on the single specimen. That means correct coding is +88313 x 3.