Pathology/Lab Coding Alert

Bill for special stains and cell blocks If your practice reports FNA slide interpretation with 88173, you'll need to know when to use additional codes like 88112 and 88305 for special aspirate processing and interpretation. 

Although CPT 88173 includes slides prepared by various cytopathology methods such as direct smears or thin layer preparation, that doesn't mean the code accounts for every FNA slide the pathologist evaluates. 

Exception: You can separately report special stains and cell blocks prepared from the FNA specimen.

Because CPT instructs you to list special-stain slides in addition to the primary service, you can report the appropriate stain code(s) with 88173 if the pathologist examines them. "CPT 2004 clarified that you can list the stains in addition to any primary service, such as an FNA, not just in addition to a surgical pathology service," says Peggy Slagle, CPC, billing compliance coordinator at the University of Nebraska Medical Center in Omaha. The special stain codes include the following:

 +88312 -- Special stains (list separately in addition to code for primary service); Group I for microorganisms (e.g., Gridley, acid fast, methenamine silver), each

 +88313 -- ... Group II, all other (e.g., iron, trichrome), except immunocytochemistry and immunoperoxidase stains, each.

Opportunity: If the pathologist prepares a cell block from the remaining FNA specimen and then examines slides prepared from the cell block, you can bill the cell block in addition to 88173 for the FNA. Use code 88305 (Level IV - Surgical pathology, gross and microscopic examination, cell block, any source).