Reprinted from April 2002 CAP TODAY
Q: Can I use the molecular cytogenetics codes 88271 through 88275
with surgical pathology code 88365 for fluorescence in situ hybridization
testing of HER-2/neu cancers?
A: Code 88365 should not be used with codes from the cytogenetics
section. Use code 88365, Tissue in situ hybridization, interpretation
and report, when a pathologist interprets tissue in situ hybridization
as an adjunctive study. If tumor morphometry is required, report code
88358 with 88365.
The molecular cytogenetics codes should be reported when in situ hybridization
is performed as a clinical laboratory study. If a physician's interpretation
is required for the test results of a patient study, then the pathologist
can use code 88291. This code is used for physician review and interpretation
after all data are collected. It is not used per procedure in the analysis.
Q: I noticed that the bone marrow biopsy and aspiration codes have
been removed from the pathology section of CPT 2002 and placed in the
surgery section. Can I still use them? Are there any restrictions?
A: Because codes 85095 and 85102 have moved to the surgery section
in CPT 2002, bone marrow aspirations are reported using code 38220, Bone
marrow aspiration, and bone marrow biopsies are reported using code
38221, Bone marrow biopsy, needle or trocar. Pathologists and other
physicians performing these bone marrow procedures may use the appropriate
code from the surgery section.
Codes 38220 and 38221 are part of the Correct Coding Initiative edits
for the Medicare program. If both codes are submitted on the same day
for the same patient, the CCI edit program will deny the aspiration procedure
unless a modifier is used appropriately. When a physician performs a bone
marrow biopsy and aspiration through the same incision during the same
patient encounter, only code 38221 should be reported, according to the
Centers for Medicare and Medicaid Services. Using the -59 modifier with
code 38220 to by-pass the CCI edit is only appropriate if the biopsy and
aspiration were performed on distinctly different anatomic sites or if
the two procedures were performed during different patient encounters
on the same date of service.
Frequently asked questions about CPT are published bimonthly in “Capitol
Scan.” This addition to CAP TODAY is a product of the CAP Economic
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.