Pathology/Lab Coding Alert

Test your coding knowledge.Determine how you would code this situation before looking at the box below for the answer.

Question: When we perform immunofluorescent (IF) tissue studies, physicians sometimes order them as an adjunct to the surgical pathology exam and sometimes as a stand-alone test. The stand-alone test requires that we perform a gross exam of the tissue and then prepare frozen section(s) for IF staining. Should we code separately for the gross (88300), the frozen section(s) (88331), and the IF (88346)? Tennessee Subscriber


Answer: You should report only CPT 88346 (Immunofluo-rescent study, each antibody; direct method) or 88347 ( indirect method) for the service you describe, depending on whether you use a direct fluorescent antibody test or an indirect method. These two codes describe anatomic pathology tissue studies for infectious agents, and they include the specimen preparation for the test. You would bill only 88300 (Level I Surgical pathology, gross examination only) if the pathologist performs a separate tissue gross exam and provides a diagnosis. Do not bill separately for grossing the tissue to prepare for the IF test.

Similarly, 88331 (Pathology consultation during surgery; first tissue block, with frozen section[s], single specimen) describes a pathologist's service that includes a diagnosis and an intraoperative report to the surgeon. You should not report this code to describe the preparation of frozen sections for an IF study.