Pathology/Lab Coding Alert

Question: I-m very confused about pathology stains. For instance, is an acid-fast bacillus stain 87206 or 88312? It is listed under both codes, so how do I know which code to use?


Pennsylvania Subscriber
Answer: Stains can be very confusing because choosing the proper code can depend on various factors -- the type of specimen and the purpose for the stain, to name two. The answer to your first question is that an acid-fast bacillus (AFB) stain can be either 87206 or 88312 depending on the specimen.

Example: If the lab performs an AFB on a sputum smear, the correct stain code is 87206 (Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types). That's because the specimen is a smear from a primary source, in this case, sputum.

On the other hand, if the lab performs an AFB stain on lung tissue biopsy because the pathologist noted granulomas and suspects a tuberculosis infection, you should report the stain as +88312 (Special stains [list separately in addition to code for primary service]; Group I for microorganisms [e.g., Gridley, acid fast, methenamine silver], each). You should use CPT special stain codes 88312-88314 when the lab performs a special stain as an adjunct to a surgical pathology exam.

Another example: If the lab performs a Giemsa stain on a peripheral blood smear, report 87205 (Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types). On the other hand, if the lab performs a Giemsa stain for bacteria on a stomach biopsy, report 88312. Reader Questions were prepared with the assistance of R. M. Stainton Jr., MD, president of Doctors- Anatomic Pathology Services in Jonesboro, Ark.