Pathology/Lab Coding Alert

Question: Our lab prepares cytospins and thin-prep slides for all fluids other than urine. We find that the methods enhance each other and give us a way to retain extra slides in case they are requested for a second opinion. Can we bill for both a cytospin and thin-prep from the same specimen when we perform both services?

Connecticut Subscriber

Answer: No, you should not report both a cytospin (CPT 88108 , Cytopathology, concentration technique, smears and interpretation [e.g., Saccomanno technique]) and a thin-layer preparation (88112, Cytopathology, selective cellular enhancement technique with interpretation [e.g., liquid-based slide preparation method], except cervical or vaginal) for the same specimen. 

National Correct Coding Initiative edits have a mutually exclusive edit pair for codes 88112 and 88108. According to your description, you are actually performing two separate procedures, not just trying to "unbundle" the concentration (cytospin) step from the thin-layer preparation. But you still should not report the two services together for the same specimen.

In Medicare's National Correct Coding Policy Manual, CMS says that you should report "only one code from a group of related codes describing a group of services that could be performed on a specimen with the same end result."

The manual has not been updated since the addition of code 88112 in CPT 2004, but it lists codes 88104-88108 as an example of this principle. This is why codes 88112 and 88108 are mutually exclusive - you would not normally perform them together because they provide the same end result for a given specimen, according to NCCI.

Only if you perform these two services on two different specimens should you override the edit pair with modifier -59 (Distinct procedural service), according to the policy manual. NCCI lists the 88112/88108 edit pair with a modifier indicator of "1," meaning that you can override the edit with the modifier.