Pathology/Lab Coding Alert

Question: Our pathologist received a bronchial lavage specimen from a Medicare patient and examined direct smears, liquid-based cellular-enhancement smears, and processed and examined slides from a cell block. The pathologist examined sliver stains on the lavage liquid-based slides, noting positive for fungus, as well as silver stains on slides from the cell block noting negative for Pneumocystis. How should we code the case? Tennessee Subscriber Answer: You should report 88112 (Cytopathology, selective cellular enhancement technique with interpretation [e.g., liquid based slide preparation method], except cervical or vaginal), 88305 (Level IV - Surgical pathology, gross and microscopic examination, Cell block, any source), and 88312 x 2 (Special stain including interpretation and report; Group I for microorganisms (e.g., acid fast, methenamine silver). Cytopathology: Although your pathologist examines the bronchial lavage using both direct smears (88104, Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation) and liquid-based smears, Medicare allows you [...]