| Reprinted from February 2004 CAP TODAY
Q: A fine-needle thyroid specimen is received in the lab for cytologic
examination. It is prepared and microscopically examined as six noncentrifuged
direct smear slides plus two smear slides prepared by thin-layer technique.
Should this specimen be reported as codes 88173 and 88112?
A: If the thin-layer technique is used on a fine-needle aspirate
specimen, report only code 88173, Cytopathology, evaluation of fine-needle
aspirate; interpretation and report. Code 88173 encompasses the fine-needle
aspirate cytologic evaluation and interpretation with report, irrespective
of the method and type of preparation and the number of slides reviewed.
All passes from one fine-needle aspirate procedure are reported as one
unit of 88173.
Medicare's National Correct Coding Initiative (NCCI), version 10.0, will
not allow separate payment for code 88112, Cytopathology, selective cellular
enhancement technique with interpretation (eg, liquid based slide preparation
method), except cervical or vaginal when billed with 88173 on the same
date for the same specimen. While this edit may be bypassed with a -59
modifier, it is inappropriate to do so unless a second specimen from a
distinct and separate procedure or site justifies its use.
Q: Does a cytospin smear constitute a “selective cellular enhancement
technique” eligible for reporting with new CPT code 88112?
A: Specimens that are evaluated by conventional cytocentrifugation
preparation should not be reported with code 88112, Cytopathology, selective
cellular enhancement technique with interpretation (eg, liquid based slide
preparation method), except cervical or vaginal. Code 88112 captures cellular
enhancement techniques that allow for concentration and enrichment of
nongynecological cytology specimens. The appropriate CPT code for a cytospin
preparation is 88108, Cytopathology, concentration technique, smears and
interpretation (eg, Saccomanno technique). Laboratories should determine
which specimen types warrant conventional cytocentrifugation in lieu of
thin-layer techniques.
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,
4th ed., CPT 2003. CPT 2003 is copyrighted by the American Medical Association.
To purchase CPT books, call the AMA at (800) 621-8335.
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