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2023 Digital Pathology Codes

The College of American Pathologists (CAP) worked with the American Medical Association (AMA) CPT Editorial Panel to establish 13 new digital pathology add-on codes. The new codes are intended to capture and report additional clinical staff work and service requirements associated with digitizing glass microscope slides for primary diagnosis. Digitization of glass microscope slides enables remote examination by the pathologist and/or in conjunction with the use of artificial intelligence (AI) algorithms. 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 new digital pathology codes will be effective January 1, 2023.

The AMA CPT also added a new heading in the Category III section with CPT instructions and guidelines to define digital pathology digitization procedures. For more information on the digital pathology codes watch the Final 2023 Medicare Payment Regulations webinar or download the slides.

CPT Category III codes 0751T-0763T 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 as noted in the below table.

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)◀

Note that the CPT instructs that these Category III codes should not be reported:

  • 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
  • Solely for clinical conference presentations (eg, tumor board interdisciplinary conferences)

The CAP is focused on promoting the use of the 13 new codes to support pathologists as they implement them in their practices in 2023. CAP Advocacy leaders provided additional detail regarding these codes in August 2022 and December 2022 webinars.

FAQs for Digital Pathology Add-on Codes

Please note these will be updated as information is released from the AMA.

CPT codes 0751T-0763T are intended to capture and report additional clinical staff work and service requirements associated with digitizing glass microscope slides for primary diagnosis.

A list of the 13 new CPT Category III code numbers, descriptors, instructions and guidelines were published to the AMA website July 1, 2022.

CPT Category III Codes are a set of temporary codes for emerging technologies, services, procedures, and service paradigms. Category III codes allow data collection for these services or procedures, unlike the use of CPT unlisted codes, which does not offer the opportunity for the collection of specific data. If a Category III code is available, this code must be reported instead of a Category I unlisted code. Category III codes are intended to be used for data collection to substantiate widespread usage or to provide documentation for the Food and Drug Administration (FDA) approval process.

The CPT Category III codes may not conform to or “meet” one or more of the following CPT Category I code requirements:

  • All devices and drugs necessary for performance of the procedure or service have received FDA clearance or approval when such is required for performance of the procedure or service.
  • The procedure or service is performed by many physicians or other qualified health care professionals across the United States.
  • The procedure or service is performed with frequency consistent with the intended clinical use (ie, a service for a common condition should have high volume, whereas a service commonly performed for a rare condition may have low volume).
  • The procedure or service is consistent with current medical practice.
  • The clinical efficacy of the procedure or service is documented in literature that meets the requirements set forth in the CPT code change application.

No. Category III codes are created for data collection, assessment, and to establish potential for payment of new services and. The new codes are intended to help pathologists, pathology practices, and laboratories providing digital pathology digitization procedures appropriately report these procedures (to a patient health record and/or payer). Any reimbursement for a CPT Category III code is determined at the Medicare Administrative Contractor (MAC) level and/or other public or private payer level, with the provider being responsible for justifying payment on a case-by-case basis.

No. CPT Category III codes are not referred to the AMA-Specialty RVS Update Committee (RUC) for valuation because no relative value units (RVUs) are assigned to these codes. Payments for these services or procedures, if applicable, are based on the policies of payers and not on a yearly Medicare fee schedule.

No. Category III add-on codes 0751T-0763T are intended to capture the increased costs associated with the Technical Component (TC) (when reported in an appropriate clinical context/as part of clinical service to a patient).  These codes should not be reported 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).

Reporting is important to demonstrate widespread use of the digital pathology digitization procedures to ensure that the codes can be considered for future Category I status CPT codes with established payment.

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 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. Digitization of glass microscope slides enables remote examination by the pathologist and/or in conjunction with the use of artificial intelligence (AI) algorithms.

The CAP recognized slide digitization for primary diagnosis was occurring and there is a need to capture the unique costs and emerging pattern of utilization of digital pathology in today’s pathology practice. The new codes will help pathologists, pathology practices, and laboratories appropriately report pathology digitization procedures. The CAP successfully advocated for the inclusion of new CPT digital pathology codes into the AMA’s CPT code set for 2023.

Category III add-on codes 0751T-0763T 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.  Do not report the Category III codes 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). (See the CAP table for code descriptors and instructional notes).

Yes, additional CAP proposals are being considered for development through the AMA CPT process in the next few years.

Category III CPT Codes are temporary codes for emerging technology, services and procedures that allow for specific data collection associated with those services and procedures. There are no assigned RVU’s or established payment for the Category III CPT codes. When these procedures become more commonly adopted and established, the CAP will work with the American Medical Association (AMA) to move these codes from Category III to Category I CPT status.

The criteria for Criteria for CPT® Category I and Category III codes can be found here:

Criteria for CPT® Category I and Category III codes | American Medical Association (ama-assn.org)