Pathology/Lab Coding Alert

Question: What is the definitive explanation regarding the non-gynecological cytology codes (88104-88108)? Based on the differentiation in CPT Codes 2001, I am unable to instruct my office staff in the correct use of these codes. An example of each code with its respective specimen identified would help.

Florida Subscriber

Answer: The four codes you mentioned are not based on a particular named specimen, rather they refer to smears made from any non-gynecological source of fluids, washings or brushings. This may include peritoneal or bronchial washings, for example. The source of the fluid, washing or brushing is not relevant as long as it is not cervical or vaginal. Instead, the proper selection of 88104-88108 depends on how the specimen is processed.

Use 88104 if cytology smears are made directly from the fluids, washings or brushings.

Use 88106 if cytology smears are made from fluids, washings or brushings processed with a filter technique.

Use 88107 if cytology smears are made directly from the fluid, washing or brushing, and also from a filter technique.

Use 88108 if cytology smears are made from the results of a concentration technique. A common example is the concentration of sputum in the Saccomanno technique. Unlike the preceding three codes, 88108 does not state fluids washings or brushings, although it did prior to 1998 when the code was modified.

Correctly using these codes does not depend on whether the fluid is from a paracentesis, esophageal washings, urine or other aspirate. Because selecting the correct code depends on how the specimen is processed, a list of specimen types is appropriate for coding direction.

Answered by William Dettwyler, MT-AMT, an independent pathology coding consultant based in Salem, Ore.