Pathology/Lab Coding Alert

Question: If we use the Vysis FISH probe kit to aid in monitoring bladder cancer, can we code the thin-prep slide in addition to the FISH test 88368?

Texas Subscriber Answer: Labs may carry out the fluorescence in situ hybridization (FISH) test for identifying chromosomal abnormalities in urine cytology on fresh urine specimens or liquid-based cytology slides. If you perform the FISH on a fresh urine specimen, you should not code for a thin-layer slide preparation.
 
But if you prepare the liquid cytology slide using a system such as CyTyc ThinPrep and then use the UroVysion FISH probes on that specimen, you can bill for both procedures.
 
The correct code for a urine ThinPrep is CPT 88112 (Cytopathology, selective cellular enhancement technique with interpretation [e.g., liquid-based slide preparation method], except cervical or vaginal).
 
The Vysis FISH kit for bladder cancer detection uses four-color interphase DNA probes, so the proper coding for the test is four units of 88368 (Morphometric analysis, in situ hybridization [quantitative or semi-quantitative], each probe; manual).
 
You may bill both 88112 and 88368 x 4 together if you perform both tests on the urine specimen.