College of American Pathologists
CAP Committees & Leadership CAP Calendar of Events Estore CAP Media Center CAP Foundation
 
About CAP    Career Center    Contact Us      
Search: Search
  [Advanced Search]  
 
CAP Home CAP Advocacy CAP Reference Resources and Publications CAP Education Programs CAP Accreditation and Laboratory Improvement CAP Members
CAP Home > CAP Reference Resources and Publications > CPT Coding Resource Center > Coding and Reimbursement Article Archive > Your CPT Questions

  Your CPT Questions

title
 

Reprinted from December 2003 CAP TODAY

Q: Is it appropriate to bill for processing and staining specimens—for example, CSF, bone marrow aspirate—when the slide yields non-diagnostic results due to an inadequate specimen or insufficient numbers of cells?

A: If the specimen is absolutely devoid of cellular elements, it should be designated as unsatisfactory or inadequate for examination, and the pathologist should not charge for an evaluation. If the specimen contains material that is reviewed for diagnostic findings and a report is issued, then the pathologist can code and bill for the service, even if the material is too scant to exclude a particular disease process.

Q: We processed an upper lobe posterior segment partial lobectomy followed by an additional partial lobectomy from the same lobe of the lung. Can these services be billed separately, or should they be reported with one code?

A: A specimen is defined by CPT as “tissue or tissues submitted for individual and separate attention, requiring individual examination and pathologic diagnosis.” A segmental resection is coded as 88309. If the partial lobectomy was submitted for separate evaluation, it would be appropriate to code it as 88309. The second segment would be coded as an additional unit of 88309. If the specimens are not separately identified or distinctly identifiable, then it would be appropriate to report as a single unit 88309.


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.

 
 

 

 

   
 
 © 2014 College of American Pathologists. All rights reserved. | Terms and Conditions | CAP ConnectFollow Us on FacebookFollow Us on LinkedInFollow Us on TwitterFollow Us on YouTubeFollow Us on FlickrSubscribe to a CAP RSS Feed