Pathology/Lab Coding Alert

Question: What is the correct code for bronchial washings? When we receive documentation for this service, it is sometimes indicated as CPT 88104 (cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation), 88108 (cytopathology, concentration technique, smears and interpretation) or 88162 (cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains). Could you please clarify?

Vernita Johnson, CPC
Florence, S.C.

Answer: To report bronchial washings, proper coding depends on the technique the pathologist used for sample processing, including direct smears and/or filter preparation (88104-88107). Although the 88104 and 88160 families of codes are both used when interpreting cytopathology smears, the 88104 family specifically states fluids, washings or brushings in the code description, making this family the appropriate choice for bronchial washings.

Code 88108 is for cytopathology smears that are processed with a concentration technique. This process may be used to detect malignant cells that are present in low concentrations in samples, such as washings. Code 88108 may be reported alone if smears are made only from the concentrated sample, or in addition to another cytopathology code if both direct and concentrated smears are evaluated.

Code 88162 applies to specimens in the 88160 family of codes. These are cytopathology smears from any source other than gynecological or non-gynecological fluids, washings or brushings. As such, none of these codes, including 88162, would be appropriate for bronchial washings.

Editors note: Laurie Castillo, MA, CPC, president of American Association of Professional Coders Northern Virginia Chapter and owner of Physician Coding & Compliance Consulting in Manassas, Va., and and Stacey Hall, ART, CPC, CCS-P, Medical Management Professionals Inc., a billing firm for physicians in Knoxsville, Tenn., answered the reader questions.