College of American Pathologists

  Your CPT Questions


Reprinted from April 2000 CAP TODAY

Q: Several pathologists in my practice disagree on which code should be used for keloid specimens. What is the correct code? And are we allowed to upcode extremely large skin specimens, such as wide excisions, to an 88307 or 88309 based on the work involved?

A: Keloids, or cheloids, typically are coded using 88305, Skin, Other than Cyst/Tag/Debridement/Plastic Repair.

The proper way to report unusually difficult or time-consuming cases is to use modifier -22, Unusual Procedural Services. However, Medicare usually will not increase payment when the modifier is used, and some private insurers do not recognize the modifier.

Q: Should I use code 85535, Iron stain (RBC or bone marrow smears), for the evaluation of an iron stain on a bone marrow aspirate?

A: No. Code 88313 is used to report the physician evaluation of an iron stain on a bone marrow analysis commonly performed as part of a complete bone marrow examination to evaluate marrow iron stores or sideroblastic anemia. This code is used to report the technical and professional components of performance of special stains on histologic, cytologic, and hematopathologic material including stains to evaluate specimens for the accumulation of iron. Code 85535 is typically used in the clinical laboratory to identify the evaluation for the abnormal accumulation of iron (seen as Pappenheimer bodies on Romanovsky stained blood smears) in mature erythrocytes (siderocytes).

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.