Reprinted from March 1996 CAP TODAY
Pathologists should use CPT code 80500 for review of cytopathology smears
and histopathology slides to determine the causes of discrepancies, the
American Medical Association’s CPT Editorial Panel advises.
CPT code 80500 is for clinical pathology consultation; limited, without
review of patient’s history and medical records. Its use requires a written
report in response to a request for the consultation by an attending physician.
The CPT advice comes in response to College requests for a new code for
the examination of discordant cytology and pathology slide(s) as required
by CLIA ’88. CLIA cytology sections 493.1257 (d) (2) and (3) say the laboratory
must compare clinical information, when available, with cytology reports
and must compare all malignant and premalignant gynecology reports with
the histopathology report, if available in the laboratory either on site
or in storage, and determine the causes of discrepancies. In addition,
each patient with a current high-grade or above intraepithelial lesion
(moderate dysplasia or CIN-2 or above), the laboratory must review all
normal or negative gynecologic specimens received within the previous
five years, if available in the laboratory either on site or in storage.
If significant discrepancies are found that would affect patient care,
the laboratory must notify the patient’s physician and issue an amended
In requesting a new code for this service, the College noted that the
service is now the expected standard of practice and can require considerable
physician time and effort. It is provided to determine the reason for
the discordance so further studies can be suggested or a clinical course
of action can be determined, not for the purpose of quality control of
the previously interpreted smears.
The CPT Editorial Panel reviews requests for revised or new CPT codes
and defines the use of existing codes. The Panel comprises physicians
of various specialties and includes representatives of the Health Insurance
Association of America, Blue Cross and Blue Shield Association, and Health
Care Financing Administration. In advising that 80500 be used for these
services, the panel also noted that the billing physician should provide
supplementary information to the insurer explaining the specific service.