College of American Pathologists

  Your CPT Questions


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 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.