Pathology/Lab Coding Alert

New codes 88333 and 88334 will help you overcome an NCCI roadblock

You've had to eat the $36 that Medicare won't pay for 88161 with 88331 since the National Correct Coding Initiative (NCCI) edits bundled the pair in January 2004. Now you can get paid for both an intraoperative frozen section and touch prep--but you won't use 88161 to do it
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Beginning Jan. 1, 2006, you should use new CPT 88333 (Pathology consultation during surgery; cytologic examination [e.g., touch prep, squash prep], initial site) and 88334 (... cytologic examination [e.g., touch prep, squash prep], each additional site) to report intraoperative pathology consultations that use touch preps, which involve crushing or touching excised tissue to a slide to remove cells for tumor evaluation. Location Distinguishes Codes You'll use new codes 88333 and 88334 only for touch preps that the pathologist performs in the surgical theater as part of a consultation with the surgeon. These codes do not replace 88161 (Cytopathology, smears, any other source; preparation, screening and interpretation). CPT 2006 includes a text note that states, "Do not report 88333 and 88334 for non-intraoperative cytologic examination, see 88160-88162."

Don't miss: "You should continue to use cytology codes for smears that are not part of a surgical consultation," says Ernest J. Conforti, MSHS, SCT (ASCP) MT, assistant director of anatomic pathology operations at North Shore-Long Island Jewish Health System, headquartered in Great Neck, N.Y. Those codes include 88160 (Cytopathology, smears, any other source; screening and interpretation), 88161 and 88162 (... extended study involving over 5 slides and/or multiple stains). 88333 Includes 88329 Service You used to report two codes when a pathologist performed a touch prep during an intraoperative consultation. But now you'll just use one new code because 88333 describes both services.

For example: The surgeon calls the pathologist to the operating room to consult on a lung biopsy. The pathologist performs a touch prep on the specimen and reports the findings and diagnosis to the surgeon during the procedure.

Old way: In 2005, you would report each service separately: 88329 for the consultation during surgery and 88161 for the touch prep.

New way: In 2006, you need only one code to report the service: 88333. "Don't report 88329 and 88333 together for an intraoperative consultation that includes a touch prep," Conforti says. Use 88333-88334 Together--Like 88331-88332 If the pathologist looks at touch preps from multiple sites during a surgical consultation, you need to use both 88333 and 88334. List 88333 for the initial touch prep and one unit of 88334 for each touch prep from additional sites. In other words, apply these codes in a fashion similar to frozen section codes, in which you use 88331 (Pathology consultation during surgery; first tissue block, and frozen section[s], [...]