Go Back   AAPC Medical Coding & Billing Forums > Medical Coding > Pathology & Clinical Laboratory
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools
  #1  
Old 03-08-2011, 07:44 AM
vnorman vnorman is offline
Networker
 
Join Date: Apr 2007
Posts: 29
vnorman is on a distinguished road
Default New Cytopathology FISH Code

I was wondering if anyone knows of a place I can find a complete (better), full description of the new pathology codes for the Cytopathology FISH tests - 88120 & 88121. This is what I have been able to find...

88120 - Cytopathology, in situ hybridization (eg FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual

88121 Using computer-assisted technology

My physician wants additional information and I have not been able to find any... Please help???

Thank you,
Valarie
Reply With Quote
  #2  
Old 03-08-2011, 11:33 AM
megan518 megan518 is offline
Contributor
 
Join Date: Apr 2007
Location: Charm City Baltimore
Posts: 23
megan518 is on a distinguished road
Post More info- 88120, 88121

Not sure if this is what you were looking for but..........I got this information from two different websites: CAP's website and Highmark Medicare. I hope you find something you can use.

For 2011, new CPT codes 88120 and 88121 were established, at payers’ request, to report fluorescence in situ hybridization evaluations of urologic cytology specimens for urothelial carcinoma using multiple probes. Codes 88367 and 88368, previously used to report these services, were established and valued in 2005 to report FISH evaluations of the HER2 gene using a single probe or, nonroutinely, multiple probes. Because codes 88367 and 88368 were not valued for reporting multiple probes, the request was to have 88367and 88368 revalued, or to establish new codes for UroVysion services.

Medicare will consider the Urinary FISH test medically reasonable and necessary in the following circumstances:

* In the initial diagnosis of persons with hematuria suspected of having bladder carcinoma, in conjunction with, and NOT IN LIEU of current standard diagnostic procedures. Therefore it is expected that Initial urinary FISH studies are performed in conjunction with cystoscopic evaluation.
* In the monitoring for tumor recurrence in conjunction with cystoscopy in patients with previously diagnosed bladder cancer.
* Monitoring for additional recurrence after one or more recurrences have been treated.

The urinary FISH test for recurrent bladder is not considered medically reasonable or necessary under the following circumstance:

* When performed to provide additional confirmatory information after a diagnosis of bladder cancer recurrence has already been determined.

Medicare will consider Bladder Tumor Antigen Stat testing medically reasonable and necessary under the following circumstances:

* The patient must have a prior diagnosis of bladder cancer.
* The patient is being monitored for a status/recurrence/metastasis of bladder cancer in conjunction with cystoscopy.

Consistent with the above, Medicare expects that the urinary FISH study will be used no more frequently than cystoscopy, and may be used additively or substituted for conventional urine cytology depending on the grade of the tumor and potential diagnostic yield. The first FISH study as the diagnosis of urothelial cancer is being established will be coded with the appropriate morphometric analysis code 88120 or 88121, and with the appropriate neoplastic diagnosis required. Subsequent studies will be additionally coded with the V-code, V49.89 OTHER SPECIFIED CONDITIIONS INFLUENCING HEALTH STATUS, to indicate that repeat testing is believed to be medically reasonable and necessary.

Urinary cytogenetic studies will not be covered if the patient has signs or symptoms of hematuria or an active infectious/inflammatory condition at the time of the testing (e.g. cystitis, urethritis, or prostatitis).
Reply With Quote
  #3  
Old 03-08-2011, 12:23 PM
vnorman vnorman is offline
Networker
 
Join Date: Apr 2007
Posts: 29
vnorman is on a distinguished road
Default Thanks

Thanks so much, that gave me so much more information. I did not find that in my searchs. Have a great day and thanks again!!
Reply With Quote
Reply

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off




Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 11:43 PM.

AAPC - Top

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
Copyright ©2014, AAPC