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88172, 88173

  1. #1
    Question 88172, 88173
    Clearnace Sale
    Hello -

    I am new to Pathology coding, and am only billing the Professional Component. Can someone tell me what service 88173 is reporting? Do we use 88172 to evaluate the adequacy of the specimen and then 88173 to actually interpret the findings (i.e. malignant, benign)?

    Thanks in advance,

  2. #2
    88172 if for "immediate" study. This is used when the cytopathologist examines the specimen intra-procedurally to let whoever is performing the FNA know whether they need to gather more material or not.

    88173 is for the interpration and report on the FNA after the procedure is concluded.

  3. #3
    Bay City Michigan Chapter
    Default 88172
    I am also quite new to the Pathology. This 88172 is being denied on all fronts because of place of service. The payers don't mind the 88173 but they are complaining about 88172. What do I need to do if my pathologist was the one performing the 88172 and notates that on his report?
    Robyn King, CPC
    St Mary's Pathology Coding/Billing

  4. #4
    Greater Pittsburgh
    if you pathologist is performing the actual fna, then look to code 10021. you can also report the 88173 and 88172 along with the 10021.

  5. #5
    Default 88172 performed during bronchoscopy
    Hi all, I have an 88172 being denied by Humana for Place of Service as well. do you all know the "fix" for this? Thanks

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