Pathology/Lab Coding Alert

Question: The pathology report describes a partial lung resection processed as six blocks labeled A1-A6. The pathologist examined acid fast bacillus stains on blocks A1, A3, A4, and A6, plus a gram stain on blocs A1, A2, A3, and A5. How should we report the stains?

Missouri Subscriber

Answer: You should code the special stains as eight units of 88312 (Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver)).

Here’s why: The acid fast bacillus (AFB) stain may help identify organisms associated with tuberculosis infection in lung tissue, and the Gram stain is another microorganism stain. For that reason, both stains report to code 88312 for microorganisms.

Further, CPT^® instruction for this code states, “Report one unit of 88312 for each special stain, on each surgical pathology block, cytologic specimen, or hematologic smear.”

That means you should list 88312 for each microorganism stain on each of the six blocks. Because the pathologist evaluated both Gram stain and AFB stain on two of the blocks, the total number of special stains evaluated on the six blocks is eight.