| Reprinted from February 2005 CAP TODAY
Q: Should a CD34 test that reports the percentage and absolute number
of CD34 cells be coded as CPT codes 86587 and 88187 for interpretation
since there is no other interpretation code for one marker?
A: new flow cytometry codes 88187, Flow cytometry, interpretation;
2 to 8 markers; 88188, Flow cytometry, interpretation; 9 to 15
markers; and 88189, Flow cy tom et ry, interpretation; 16 or more
markers were developed to report physician evaluation of flow cytometric
immunophenotyping of hematolymphoid malignancies for panels with two or
more markers. No CPT code is available for evaluating a single marker.
CPT code 86587, Stem cells (ie, CD34), total count, describes the
total count of positive stem cells commonly performed in immunocompetency
or transplant assessment, or both. A pathologist is not usually required
to interpret the results when flow cytometry is performed to assess and
monitor absolute cell counts immunophenotypically.
Quantitative analyses are technical component-only services without an
associated professional interpretation. They should not be reported with
anatomic pathology flow cytometry services unless the services are performed
for separate clinical evaluations. Therefore, only code 86587 should be
billed for this service. It is not appropriate to bill for the immunophenotypic
enumeration codes separately under the respective quantitative codes—for
example, 86064, 86379, and 86587—when the codes are performed as
part of an interpretive panel.
Q: Can you bill CPT codes 88172 and 88173 together for the same fine-needle
aspirate specimen? If so, under what circumstances?
A: codes for immediate determination of adequacy and definitive
interpretation are reported per aspirate requiring separate evaluation
and are not inclusive of each other. Each code may be reported separately.
So, for example, if an immediate evaluation of specimen adequacy is performed
to assure the presence of diagnostic material in conjunction with a subsequent
final diagnostic interpretation and report of the specimen, it would be
appropriate to bill codes 88172, Cytopathology, evaluation of fine
needle aspirate; immediate cytohistologic study to determine adequacy
of specimen(s), and 88173, Cy to pa thol ogy, evaluation of fine needle
aspirate; interpretation and report.
Frequently asked questions about CPT are published bimonthly in “Capitol
Scan.” This section of 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 2004. CPT 2004 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. |
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