Your CPT Questions

February 2005

Q: Should a CD34 test that reports the percentage and absolute number of CD34 cells be coded as CPT codes 86587 and 88187 for interpretation since there is no other interpretation code for one marker?

A. The new flow cytometry codes 88187, Flow cytometry, interpretation; 2 to 8 markers; 88188, Flow cytometry, interpretation; 9 to 15 markers; and 88189, Flow cytometry, interpretation; 16 or more markers were developed to report physician evaluation of flow cytometric immunophenotyping of hematolymphoid malignancies for panels with two or more markers. No CPT code is available for evaluating a single marker. CPT code 86587, Stem cells (ie, CD34), total count, describes the total count of positive stem cells commonly performed in immunocompetency or transplant assessment, or both. A pathologist is not usually required to interpret the results when flow cytometry is performed to assess and monitor absolute cell counts immunophenotypically.

Quantitative analyses are technical component-only services without an associated professional interpretation. They should not be reported with anatomic pathology flow cytometry services unless the services are performed for separate clinical evaluations. Therefore, only code 86587 should be billed for this service. It is not appropriate to bill for the immunophenotypic enumeration codes separately under the respective quantitative codes-for example, 86064, 86379, and 86587-when the codes are performed as part of an interpretive panel.

Q: Can you bill CPT codes 88172 and 88173 together for the same fine-needle aspirate specimen? If so, under what circumstances?

A. The codes for immediate determination of adequacy and definitive interpretation are reported per aspirate requiring separate evaluation and are not inclusive of each other. Each code may be reported separately. So, for example, if an immediate evaluation of specimen adequacy is performed to assure the presence of diagnostic material in conjunction with a subsequent final diagnostic interpretation and report of the specimen, it would be appropriate to bill codes 88172, Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy of specimen(s), and 88173, Cytopathology, evaluation of fine needle aspirate; interpretation and report.

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.