Distinguish Between These Iron Stain Tests
Question: What is the difference between codes 85536 and 88313 for iron stain? Indiana Subscriber Answer: The basic difference between the two stains is that 85536 (Iron stain, peripheral blood) is a test on blood, whereas 88313 (Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry) is a test on bone marrow or other tissues. To go into greater depth, 85536 describes a test on a peripheral blood specimen to identify siderotic granules, which are iron deposits in red blood cells that are not incorporated into a hemoglobin molecule. The test is performed on patients whose spleen or liver are enlarged or who have unexpectedly developed anemia. In contrast, clinicians may order 88313 to assess ferric iron in bone marrow stores to help evaluate conditions such as anemia, iron overload, or myelodysplasia, although the test is not limited to any specific condition. The term “Group II, all other” in the descriptor indicates that the test is not for Group I, microorganisms, or Group III, enzyme constituents. These tests are described by 88312 (Special stain including interpretation and report; Group I for microorganisms …) and 88319 (Special stain including interpretation and report; Group III, for enzyme constituents), respectively. Unlike 85536, all the special stain tests requrire professional interpretation. Remember: A CPT® text note follows code 85536 that states, “For iron stains on bone marrow or other tissues with physician evaluation, use 88313.” Bruce Pegg, BA, MA, CPC, CFPC, Managing Editor, AAPC
