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Answer: Because the Clinical Laboratory Improve-ment Amendments (CLIA) require a correlation of gynecological cytology and histology results, pathologists must have a way to report the service for evaluating any discordant results. When reviewing material internally within the same institution, the service should be reported as 80500 (clinical pathology consultation; limited, without review of patient's history and medical records).
According to CAP Today, June 2000, this direction came from the American Medical Association's CPT Editorial Panel in response to a request from CAP.
Because 80500 describes a consultation service, certain conditions must be met to use the code. The procedure must be requested by the attending physician, must involve the exercise of medical judgment on the part of the pathologist, and must entail a written report. Also, a pathology consultation must relate to test results that lie outside the clinically significant norm, such as a discrepancy between cytology and histology tests.
These consultation requirements mean the attending physician must request the correlation in order for the pathologist to report 80500. Similarly, the service can only be reported to evaluate discordant results, not for quality-control correlation of cytology and histology results.
If the slides are referred from a different institution, the pathologist should not report 80500, but should instead use 88321 (consultation and report on referred slides prepared elsewhere).
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