College of American Pathologists
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October 2002 CPT Feature

Q.   What is the correct way to report immunocytochemistry stains? For example, how many units of 88342 should we use to report a HMB-45 stain performed on two blocks of a single sentinel lymph node biopsy for melanoma? A.   If you apply the HMB-45 stain to two blocks of a single sentinel lymph node specimen, report one unit of 88342. Code 88342, Immunocytochemistry (including tissue immunoperoxidase), each antibody, is reported once for each antibody applied to a single specimen. The code should not be reported per slide or per block if multiple slides or blocks from a single specimen are stained. When multiple smears prepared from a specimen are stained with one antibody, report only one unit of 88342. If a specimen is stained with multiple antibodies, report 88342 once for each antibody used.

Q.   Our laboratory occasionally receives Tzanck smears, which we process and examine in the same manner as other cytology smears. When reporting such a service, should we use code 87207? A.  Use code 87207, Smear, primary source, with interpretation; special stain for inclusion bodies or intracellular parasites (e.g., malaria, kala azar, herpes), when an examination reports only the presence or absence of inclusions. This examination is usually performed by a technologist.
Use code 88160, Cytopathology, smears, any other source; screening and interpretation, or 88161, Cytopathology, smears, any other source; preparation, screening and interpretation, for direct Tzanck smears examined by a pathologist that require a broader service with consideration of etiology beyond simply reporting the presence of inclusions. Use code 88161 when pathologists or their designees prepare the smears.

Frequently asked questions about CPT are published bimonthly in "Capitol Scan." This section of CAP TODAY is a product of the CAP Professional and Economic Affairs Committee.

The codes and descriptions listed here are from Current Procedural Terminology, 4th ed., CPT 2002. CPT 2002 is copyrighted by the American Medical Association. To purchase CPT books, call the AMA at 800-621-8335.
For more information about CPT coding, visit the CPT Coding Resource Center on the CAP Web site.