| Reprinted from February 2003 CAP TODAY
Q: I receive vas deferens and fallopian tubes from sterilization procedures.
Sometimes more than one specimen from a sterilization procedure is placed
in a container. When this happens, can I report two units of 88302?
A: If one of the specimens in the container is identified separately
by some means, such as a suture, then two units of service are appropriate.
The specimen is the unit of service for surgical pathology codes 88300-88309.
A specimen is defined by the American Medical Association in CPT as "tissue
or tissues that is (are) submitted for individual and separate attention,
requiring individual examination and pathologic diagnosis." Therefore,
because two tissues were submitted in the same container does not automatically
mean that only one unit of service should be submitted. If each tissue
was identified for separate attention, then each should be assigned an
appropriate unit of service depending. One way to determine if specimens
are separate is to ask whether the pathologist must handle and diagnose
each tissue individually.
Q: What are category III codes, and do I have to use them if another
code in CPT approximates the service?
A: Category III codes were established by the American Medical
Association as a set of temporary CPT codes for emerging technologies,
services, and procedures where data collection is needed to substantiate
widespread use or for the FDA approval process. If a category III code
has not been proposed and accepted into the main body of CPT (Category
I) within five years, it is archived unless there is a demonstrated need
for it. In the introduction of the CPT book, users are instructed not
to select a code that merely approximates the service provided. The code
should accurately identify the service performed. Therefore, if a category
III code is available and describes the service provided, it should be
used in lieu of a category I code. This rule also applies to such category
I unlisted services codes as 87999, Unlisted microbiology procedure,
and 88199, Unlisted cytopathology procedure. Category III codes
follow the medicine section in the CPT book. The codes are updated semiannually
in January and July, and new codes are posted on the AMA’s website (www.ama-assn.org).
Frequently asked questions about CPT are published bimonthly in “Capitol
Scan.” This addition to CAP TODAY is a product of the CAP Economic
Affairs Committee.
The codes and descriptions listed here are from Current Procedural Terminology,
a copyrighted publication of the American Medical Association. To purchase
CPT books, call the AMA at (800) 621-8335.
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