College of American Pathologists

  Your CPT Questions


Reprinted from December 1999 CAP TODAY

Q: When we evaluate the margins of a lumpectomy, sometimes we perform a touch prep on several different margins. Can we report code 88161 for each margin of a specimen, or are we restricted to using the code only once per specimen?

A: Cytologic touch or crush preps of tissue are coded using 88161, Cytopathology, smears, any other source; preparation, screening and interpretation, which appears under the cytopathology section of CPT. This code can be used per site examined. For example, if, in the examination for adequacy of excision, it is medically necessary to prepare and examine separately identified slides from multiple sites—that is, margins—then it would be appropriate to use 88161 for each examination with a report using multiple units of service.

Q: Recently I have received denials from Medicare for jointly submitting cytology codes 88104 and 88108. Can I no longer submit these codes together?

A: As a result of a recent National Correct Coding Initiative for Part B of Medicare carriers, an edit has been added which indicates that codes 88104, Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation, and 88108, Cytopathology, concentration technique, smears and interpretation (eg, Saccomano technique), cannot be submitted together without a modifier. When these services are necessary on the same date of service for a patient, use the -59 modifier on code 88104 when submitting the codes. Modifier -59 is used to identify procedures/services that are not normally reported together but are appropriate under the circumstances.

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.