Ask the Expert

This month’s selection:
Are any CPT codes available for anatomic pathologists using scanned slides to read rapid interpretation (touch preps/fine needle aspiration) at their desk when the procedure is performed at off-site area such as radiology or a doctor’s office? I cannot locate any even in the Category II or III codes but can easily miss them.

I know CPT codes exist for face-to-face via computer with patients or physicians during consultation. Are these suitable for the pathologist to use? If so, which one(s) would be appropriate?

Kathleen
Alabama

Response:
There is no guidance on this question in the AMA’s CPT-4 book nor the CPT Assistant publication. But, per the Pathology Coding Manual section 8.2, the pathologist could code 88172/88177 for a rapid cytologic interpretation.

88172: Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site.

88177: Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site. (List separately in addition to code for primary procedure.)

However, the interpretation has to be done while the patient is still “on the table” to make it medically necessary and reimbursable. If the interpretation is done after the procedure is completed, then there is no medical necessity, nor does the service fit the CPT description anymore since “determining adequacy” must be done before the procedure is completed.

— Jean Stoner, CPC, RCC, is the lead subject matter expert for natural language processing for CodeRyte.