April 2009

Q. Would cytology specimens label­ed “cyst aspirate” or “FNA of cyst” be billed using the non-fine–needle aspiration cytopathology evaluation codes, depending on the method of preparation?

A. A fine-needle aspirate of a breast cyst that produces the usual type of cyst fluid should be coded based on the processing technique used. For a selective cellular enhancement method, such as ThinPrep, CPT code 88112, Cytopathology, selective cellular enhancement technique with interpretation (e.g., liquid based slide preparation method), except cervical or vaginal, would be appropriate. An FNA for a “mass lesion” would be assigned CPT code 88173, Cytopathology, evaluation of fine needle aspirate; interpretation and report.

Q. Can CPT code 88307, Level V—surgical pathology, gross and micro­scopic examination, ever be used for a wide excision of skin—for example, multiple inked, oriented margins, such as a melanoma re-excision? The examination of this specimen seems like a lot of work to be coded as 88305, Level IV—surgical pathology, gross and microscopic examination.

A. CPT code 88305 should be used to report examination of a malignant melanoma specimen and other skin cancer specimens. It is not appropriate to use CPT code 88307 even though a margin assessment was required.

“Your CPT Questions” is a product of the CAP Economic Affairs Committee. The codes and descriptions listed here are from Current Procedural Terminology, 4th ed., CPT 2009. CPT 2009 is copyrighted by the American Medical Association. To purchase CPT books, call the AMA at 800-621-8335.
For more information about CPT coding, visit the CPT Coding Resource Center on the CAP Web site, or go to Reference Resources and Publications/CPT Coding.