Pathology/Lab Coding Alert

Question: The pathology report for a bone marrow case documents iron stains on blocks A1 and A2 of a bone marrow biopsy, plus iron stains on three direct smears from a bone marrow aspiration specimen, plus an iron stain on the cell block from the bone marrow aspiration. How many iron stains can I bill?

Maine Subscriber

Answer: The correct coding for this case is six units of 88313 (Special stain including interpretation and report; Group II, all other [e.g., iron, trichrome], except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry).

Here’s why: A CPT^® text note following code 88313 states, “Report one unit of 88313 for each special stain, on each surgical pathology block, cytologic specimen, or hematologic smear.”

With that instruction, you should count the iron stains as follows:

• bone marrow biopsy block A1 iron stain - one unit 88313
• bone marrow biopsy block A2 iron stain - one unit 88313
• iron stains on three direct smears from bone marrow aspiration - three units 88313
• iron stain on cell block from bone marrow aspiration - one unit 88313.