Digital Pathology Codes

The College of American Pathologists (CAP) worked with the American Medical Association (AMA) CPT Editorial Panel to establish 30 new digital pathology add-on codes (Table 1: CPT 2024) for 2024. Digitization of glass microscope slides enables remote examination by the pathologist and/or in conjunction with the use of artificial intelligence (AI) algorithms. Category III add-on codes 0751T-0763T, and new codes 0827T-0856T are intended to capture and report additional clinical staff work and service requirements associated with digitizing glass microscope slides for primary diagnosis. As a result of CAP advocacy, the new codes will help pathologists, pathology practices, and laboratories providing digital pathology digitization procedures appropriately report these services. The Digital Pathology CPT instructions were also revised clarifying that each Category III add-on code is reported as a one-to-one unit of service for each primary pathology service code (CPT Instruction and Guidelines). The new Digital Pathology codes will be effective January 1, 2024.

You can find Digital Pathology 2023 add-on codes (Table 2: CPT 2023) here for more information. You can find Digital Pathology FAQs (under revision) here.

CPT Instruction and Guidelines

Revised CPT Subsection Introduction

Digital pathology is a dynamic, image-based environment that enables the acquisition, management, and interpretation of pathology information generated from digitized glass microscope slides.

►Glass microscope slides are scanned by clinical staff, and captured whole-slide images (either in real-time or stored in a computer server or cloud-based digital image archival and communication system) are used for digital examination for pathologic diagnosis distinct from direct visualization through a microscope. Static digital photographic and photomicrographic imaging or digital video streaming of any portion of a glass microscope slide on mobile smartphone and tablet devices does not constitute a digital pathology digitization procedure.

Digitization of glass microscope slides enables remote examination by the pathologist and/or in conjunction with the use of artificial intelligence (AI) algorithms. Category III add-on codes 0751T-0763T, 0827T-0856T may be reported in addition to the appropriate Category I service code when the digitization procedure of glass microscope slides is performed and reported in conjunction with the Category I code for the primary service. Each Category III add-on code is reported as a one-to-one unit of service for each primary pathology service code◄

Do not report the Category III codes in this subsection solely for archival purposes (eg, after the Category I service has already been performed and reported), solely for educational purposes (eg, when services are not used for individual patient reporting), solely for developing a database for training or validation of AI algorithms, or solely for clinical conference presentations (eg, tumor board interdisciplinary conferences).

Table 1: CPT 2024 DIGITAL PATHOLOGY DIGITIZATION PROCEDURE CODES

CPT Code	Long Descriptor
#+0827T	Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (List separately in addition to code for primary procedure) ▶(Use 0827T in conjunction with 88104)◀
#+0828T	Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (List separately in addition to code for primary procedure) ▶Use 0828T in conjunction with 88106)◀
#+0829T	Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, Saccomanno technique) (List separately in addition to code for primary procedure) ▶(Use 0829T in conjunction with 88108)◀
#+0830T	Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (List separately in addition to code for primary procedure) ▶(Use 0830T in conjunction with 88112)◀
#+0831T	Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (List separately in addition to code for primary procedure) ▶(Use 0831T in conjunction with 88141)◀ ▶(Do not report 0831T in conjunction with 88141, when digitization of glass microscope slides is performed using an automated, computer-assisted screening imaging system) ◀
#+0832T	Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (List separately in addition to code for primary procedure) ▶(Use 0832T in conjunction with 88160)◀
#+0833T	Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (List separately in addition to code for primary procedure) ▶(Use 0833T in conjunction with 88161)◀
#+0834T	Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (List separately in addition to code for primary procedure) ▶(Use 0834T in conjunction with 88162)◀
#+0835T	Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (List separately in addition to code for primary procedure) ►(Use 0835T in conjunction with 88172)◀ ▶(Do not report 0835T in conjunction with 88172, when 0837T is reported in conjunction with 88173)◀
#+0836T	Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in addition to code for primary procedure) ▶(Use 0836T in conjunction with 88177)◀ ▶(Do not report 0836T in conjunction with 88177, when 0837T is reported in conjunction with 88173)◀
#+0837T	Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (List separately in addition to code for primary procedure) ▶(Use 0837T in conjunction with 88173)◀
#+0838T	Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (List separately in addition to code for primary procedure) ▶(Use 0838T in conjunction with 88321)◀ ▶(Do not report 0838T in conjunction with 88321 for referred digitized glass microscope slides prepared elsewhere)◀
#+0839T	Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (List separately in addition to code for primary procedure) ▶(Use 0839T in conjunction with 88323)◀ ▶(Do not report 0839T in conjunction with 88323 for referred digitized glass microscope slides prepared elsewhere)◀
#+0840T	Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (List separately in addition to code for primary procedure) ▶(Use 0840T in conjunction with 88325)◀ ▶(Do not report 0840T in conjunction with 88325 for referred digitized glass microscope slides prepared elsewhere)◀
#+0841T	Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (List separately in addition to code for primary procedure) ▶(Use 0841T in conjunction with 88331)◀
#+0842T	Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ▶(Use 0842T in conjunction with 88332)◀
#+0843T	Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (List separately in addition to code for primary procedure) ▶(Use 0843T in conjunction with 88333)◀
#+0844T	Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (List separately in addition to code for primary procedure) ▶(Use 0844T in conjunction with 88334)◀
#+0845T	Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (List separately in addition to code for primary procedure) ▶(Use 0845T in conjunction with 88346)◀
#+0846T	Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ▶(Use 0846T in conjunction with 88350)◀
#+0847T	Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) (List separately in addition to code for primary procedure) ▶(Use 0847T in conjunction with 88363)◀ ▶(Do not report 0847T in conjunction 88363, when digitization of glass microscope slides has been previously reported)◀
#+0848T	Digitization of glass microscope slides for in situ hybridization (eg, FISH), per specimen; initial single probe stain procedure (List separately in addition to code for primary procedure) ▶(Use 0848T in conjunction with 88365)◀
#+0849T	Digitization of glass microscope slides for in situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ▶(Use 0849T in conjunction with 88364)◀
#+0850T	Digitization of glass microscope slides for in situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure (List separately in addition to code for primary procedure) ▶(Use 0850T in conjunction with 88366)◀
#+0851T	Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (List separately in addition to code for primary procedure ▶(Use 0851T in conjunction with 88368)◀
#+0852T	Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ▶(Use 0852T in conjunction with 88369)◀
#+0853T	Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (List separately in addition to code for primary procedure) ▶(Use 0853T in conjunction with 88377)◀
#+0854T	Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (List separately in addition to code for primary procedure) ▶(Use 0854T in conjunction with 85060)◀ ▶(Do not report 0854T in conjunction with 85060, when digitization of glass microscope slides is performed using an automated, computer-assisted cell morphology imaging analyzer)◀
#+0855T	Digitization of glass microscope slides for bone marrow, smear interpretation (List separately in addition to code for primary procedure) ▶(Use 0855T in conjunction with 85097)◀
#+0856T	Digitization of glass microscope slides for electron microscopy, diagnostic (List separately in addition to code for primary procedure) ▶(Use 0856T in conjunction with 88348)◀

Table 2: CPT 2023 DIGITAL PATHOLOGY DIGITIZATION PROCEDURE CODES

CPT Code	Long Descriptor
+0751T	Digitization of glass microscope slides for level II, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) ►(Use 0751T in conjunction with 88302)◄
+0752T	Digitization of glass microscope slides for level III, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) ▶(Use 0752T in conjunction with 88304)◀
+0753T	Digitization of glass microscope slides for level IV, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) ▶(Use 0753T in conjunction with 88305)◀
+0754T	Digitization of glass microscope slides for level V, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) ▶(Use 0754T in conjunction with 88307)◀
+0755T	Digitization of glass microscope slides for level VI, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) ▶(Use 0755T in conjunction with 88309)◀
+0756T	Digitization of glass microscope slides for special stain, including interpretation and report, group I, for microorganisms (eg, acid fast, methenamine silver) (List separately in addition to code for primary procedure) ▶(Use 0756T in conjunction with 88312)◀
+0757T	Digitization of glass microscope slides for special stain, including interpretation and report, group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (List separately in addition to code for primary procedure) ▶(Use 0757T in conjunction with 88313)◀
+0758T	Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ▶(Use 0758T in conjunction with 88314)◀
+0759T	Digitization of glass microscope slides for special stain, including interpretation and report, group III, for enzyme constituents (List separately in addition to code for primary procedure) ▶(Use 0759T in conjunction with 88319)◀
+0760T	Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (List separately in addition to code for primary procedure) ▶(Use 0760T in conjunction with 88342)◀
+0761T	Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (List separately in addition to code for primary procedure) ▶(Use 0761T in conjunction with 88341)◀
+0762T	Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (List separately in addition to code for primary procedure) ▶(Use 0762T in conjunction with 88344)◀
+0763T	Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (List separately in addition to code for primary procedure) ▶(Use 0763T in conjunction with 88360)◀

CAP Advocacy leaders provided additional detail regarding the 2023 codes see CAP Advocacy leaders article, August 2022 and December 2022 webinars.