CPT Feature

February 2003

Q.  I receive vas deferens and fallopian tubes from sterilization procedures. Sometimes more than one specimen from a sterilization procedure is placed in a container. When this happens, can I report two units of 88302?

A.  If one of the specimens in the container is identified separately by some means, such as a suture, then two units of service are appropriate.

The specimen is the unit of service for surgical pathology codes 88300-88309. A specimen is defined by the American Medical Association in CPT as "tissue or tissues that is (are) submitted for individual and separate attention, requiring individual examination and pathologic diagnosis." Therefore, because two tissues were submitted in the same container does not automatically mean that only one unit of service should be submitted. If each tissue was identified for separate attention, then each should be assigned an appropriate unit of service.

One way to determine if specimens are separate is to ask whether the pathologist must handle and diagnose each tissue individually.

Q.  What are category III codes, and do I have to use them if another code in CPT approximates the service?

A.  Category III codes were established by the American Medical Association as a set of temporary CPT codes for emerging technologies, services, and procedures where data collection is needed to substantiate widespread use or for the FDA approval process. If a category III code has not been proposed and accepted into the main body of CPT (category I) within five years, it is archived unless there is a demonstrated need for it.

In the introduction of the CPT book, users are instructed not to select a code that merely approximates the service provided. The code should accurately identify the service performed. Therefore, if a category III code is available and describes the service provided, it should be used in lieu of a category I code. This rule also applies to such category I unlisted services codes as 87999, Unlisted microbiology procedure, and 88199, Unlisted cytopathology procedure.

Category III codes follow the medicine section in the CPT book. The codes are updated semiannually in January and July, and new codes are posted on the AMA Web site, www.ama-assn.org.
Frequently asked questions about CPT are published bimonthly in “Capitol Scan.” This section of CAP TODAY is a product of the CAP Professional and Economic Affairs Committee.

The codes and descriptions listed here are from Current Procedural Terminology, 4th ed., CPT 2002. CPT 2002 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.