CPT Questions

February 2004

Q: A fine-needle thyroid specimen is received in the lab for cytologic examination. It is prepared and microscopically examined as six noncentrifuged direct smear slides plus two smear slides prepared by thin-layer technique. Should this specimen be reported as codes 88173 and 88112?

A. If the thin-layer technique is used on a fine-needle aspirate specimen, report only code 88173, Cytopathology, evaluation of fine-needle aspirate; interpretation and report. Code 88173 encompasses the fine-needle aspirate cytologic evaluation and interpretation with report, irrespective of the method and type of preparation and the number of slides reviewed. All passes from one fine-needle aspirate procedure are reported as one unit of 88173.

Medicare’s National Correct Coding Initiative (NCCI), version 10.0, will not allow separate payment for code 88112, Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal when billed with 88173 on the same date for the same specimen. While this edit may be bypassed with a -59 modifier, it is inappropriate to do so unless a second specimen from a distinct and separate procedure or site justifies its use.

Q: Does a cytospin smear constitute a “selective cellular enhancement technique” eligible for reporting with new CPT code 88112?

A. Specimens that are evaluated by conventional cytocentrifugation preparation should not be reported with code 88112, Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal. Code 88112 captures cellular enhancement techniques that allow for concentration and enrichment of nongynecological cytology specimens. The appropriate CPT code for a cytospin preparation is 88108, Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique). Laboratories should determine which specimen types warrant conventional cytocentrifugation in lieu of thin-layer techniques.

Frequently asked questions about CPT are published bimonthly in “Capitol Scan.” This section of CAP TODAY is a product of the CAP Economic Affairs Committee.

The codes and descriptions listed here are from Current Procedural Terminology, 4th ed., CPT 2006. CPT 2006 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.