Pathology/Lab Coding Alert

Question: We have a reference lab performing our flow cytometry panels, but our pathologists interpret the panels in light of their own findings from the tissue pathology examination. How should we code for the professional-only flow cytometry service -- do we need to use a modifier?

Michigan Subscriber

Answer: CPT breaks flow cytometry panels into technical and professional components by providing separate codes for each.

Your pathologist should report the professional interpretation of the entire panel by selecting one of the following codes, based on the total number of markers in the panel:

- 88187 -- Flow cytometry, interpretation; 2 to 8 markers

- 88188 -- - 9 to 15 markers

- 88189 -- - 16 or more markers.

Unlike many pathology procedures, these codes are not "global" -- they don't represent a combined technical and professional service. That means you should not use modifier 26 (Professional component) to report your pathologist's panel interpretation. The appropriate code (such as 88188) represents a professional-only service.

Your reference lab should report the technical portion that it performs with the following two codes:

- 88184 -- Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker

- +88185 -- - each additional marker (list separately in addition to code for first marker).

The reference lab should list multiple units of 88185 based on the number of markers beyond the first marker.

Similar to the professional codes, the lab should not report 88184 and 88185 with modifier TC (Technical component) because the codes represent a technical-only service.