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The digital pathology digitization procedure can be intimidating at first glance. Not only are they relatively new codes, having been introduced to the CPT^® code set just two years ago, but they are also Category III codes and add-on codes as well. That means you have a steep, but thankfully short, learning curve ahead of you before you can use them correctly.

That’s why we’ve assembled these frequently asked questions (FAQs) for these codes; the following answers will help you implement these codes accurately whenever your lab digitizes glass microscope slides for immediate or later pathologic diagnoses.

What Are Digital Pathology and Glass Microscope Slide Digitalization?

The Digital Pathology Association (DPA) describes digital pathology as “a dynamic, image-based environment that enables the acquisition, management and interpretation of pathology information generated from a digitized glass slide.” The process of slide imaging, the DPA goes on to explain, is “the high-resolution digital capture of glass slides to generate ‘virtual slides.’ It consists of a microscope designed to scan one or more slides in an automated fashion (the whole-slide scanner) and accompanying image viewing software that allows users to navigate a slide in a manner similar to Google Maps.”

This explains why the College of American Pathologists (CAP) worked with the CPT^®  Editorial Panel to establish new CPT^®  codes for capturing and reporting “additional clinical staff work and service requirements associated with digitizing glass microscope slides for primary diagnosis.” CPT^®  designates the codes as both temporary (four numerals followed by “T” in the Category III section) and add-on, meaning they describe procedures that are “always performed in addition to the primary service or procedure and must never be reported as a stand-alone code,” per CPT^® guidelines.

How Should I Use the Glass Microscope Slide Digitization Codes?

CPT^® links each of these add-on codes to a specific primary procedure based on the code definition and a text note associated with the code. For instance, you’ll use +0763T (Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (List separately in addition to code for primary procedure)) only in addition to primary procedure code 88360 (Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual). A note following +0763T states “Use +0763T in conjunction with 88360.”

Here are all the current primary service codes with their add-on codes:

What About 88361?

While morphometric analysis code 88360 has a slide digitization add-on code, the other morphometric analysis code, 88361 (Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology), does not. That’s because the words “using computer-assisted technology” tells you the “CPT^®  code already recognizes the digitization process. Therefore, no additional digital pathology CPT^®  code is needed,” according to CAP.

Why Should I Use the Codes?

None of the glass microscope slide digitization codes carry a monetary value per the Medicare Physician Fee Schedule; they have 0 work, practice expense, or malpractice relative value units (RVUs). But this does not mean you shouldn’t bother adding them to your claims.

Rather, the CAP strongly encourages your use of the codes for two very important reasons. First, when paired with their primary service codes, their use can be seen “to be of value in direct patient care to an individual patient,” and that slide digitation is “being used for primary diagnosis and deserves reimbursement.” Second, use will enable use of the process to be tracked, ultimately enabling justification for “moving [the temporary Category III codes] to Category I, where they can be valued nationally for payment.”

Bruce Pegg, BA, MA, CPC, CFPC, Managing Editor, AAPC