Your CPT Questions

Reprinted from August 2000 CAP TODAY

Q: I use the Thin Prep technique on some nongynecologic cytology specimens. Which CPT code is most appropriate, 88107, Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears and filter preparation with interpretation, or 88108, Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique)?

A: The Thin Prep technique is a concentration technique and, when used for nongynecological cytology specimens, should be coded using 88108. Although the Saccomanno technique is specifically mentioned in this code, it is only an example. Other concentration techniques include cytocentrifugation and cytospin.

Code 88108 is reportable in conjunction with codes 88104 through 88107 and 88160 through 88162 when a concentration technique is performed in addition to the services described in these codes. However, there are Medicare Part B Correct Coding Initiative edits against reporting these codes together without a modifier. When 88104 and 88108 services are necessary on the same date for a patient, use modifier -59, Distinct Procedural Service, with 88104. Likewise, use the -59 modifier with 88108 when it is necessary to submit this code in conjunction with codes 88106, 88107, or 88162 on the same date for a patient.

If the Thin Prep technique is used on a fine needle aspirate specimen, the appropriate code is 88173, Evaluation of fine needle aspirate with or without preparation of smears; interpretation and report.

Q: Can code 80100, Drug screen; multiple drug classes, each procedure, be reported more than once for a qualitative drug screening if I am screening to detect drugs from more than one class? Can 80101, Drug screen; single drug class, each drug, be used multiple times if the test is performed using a rapid assay kit?

A: Under code 80100, each combination of stationary and mobile phase is considered one procedure. If screening for multiple drugs by chromatography requires one stationary phase with multiple mobile phases, then use as many units of 80100 as there are mobile phases. If, however, multiple drugs can be detected using a single analysis, use one unit of 80100. Use 80102, Drug, confirmation, each procedure, to report the confirmatory test without quantification. Each combination of stationary and mobile phase counts as one procedure.

Code 80101 can be used regardless of whether one is reporting a test using a random access analyzer or a single or multiple analyte test kit. Each single drug class method that is tested and reported counts as one drug class. For example, if a sample is run on a single rapid assay kit containing multiple class-specific immunoassays, then each class receives a separate unit of 80101.

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.