Pathology/Lab Coding Alert

Question: Our pathologist examined a kidney biopsy using the following special "IF" stains: CD4, IgA, IgG, IgM, kappa, and lambda. Are the stains 88313 since they are not for microorganisms?

Michigan Subscriber

Answer: For the stains you listed, you should not use 88313 (Special stains [list separately in addition to code for primary service]; Group II, all other [e.g., iron, trichrome], except immunocytochemistry and immunoperoxidase stains).

The stains listed in your question are antibody studies using an immunofluorescent (IF) marker, so they qualify as one of the types excluded from the 88313 definition.

Instead, you should report each separate stain using the appropriate immunofluorescent-antibody code:

- 88346 -- Immunofluorescent study, each antibody; direct method

- 88347 -- - indirect method.

Code this way: The IgA, IgG, IgM, kappa and lambda immunofluorescent studies usually use the direct method. You should report 88346 x 5, because the pathologist examined slides with five different antibody markers by that method.

The CD4 fluorescent antibody marker is typically an indirect method -- report that antibody stain as 88347.

Don't miss: You should report the tissue exam for the kidney biopsy as 88305 (Level IV -- Surgical pathology, gross and microscopic examination; kidney, biopsy).