[Histonet] FNA code

Thu Dec 31 15:10:01 CST 2009

Mary, I'd have to disagree.

88173 has both a technical and professional component. This is well documented in a resource your dept might find very beneficial entitled "Pathology Service Coding Handbook" which is authored by Dennis Padgett, a noted coding authority.

It is customary to have a cytotechnologist screen FNA smears or Thin Prep slides prior to the slides going to sign out with the pathologist. And of course the hospital incurs supply expenses as well as labor expense associated with the preparation of the specimen(s) that will be interpreted

The rule of thumb is as follows:

88173 should be dropped for every Fine Needle Aspirate. This represents all of the work in the laboratory (including prep and staining) that leads to the interpretation both technical and professional

88172 is dropped only if the procedure is attended by a pathologist or cytotechnologist to render an adequacy during the procedure. This presumes that the aspirate is not being performed by the pathologist but another clinician, radiologist, etc.

It is appropriate to drop additional codes to 88173, such as codes for cell block (88305), special stains (88312;88313), IHC (88342) or thin layer preparation of the aspirate (88112 ) however it may interest you to know that, according to Padgett,  Medicare will never pay 88112 when it is added onto 88173. so for example, if you do direct smears and thin prep on an FNA specimen, Medicare will still only pay for 88173.

Other payors may vary and for simplicity it may be simpler for labs to drop 88112 whenever thin prep is done on a FNA specimen without regard to payor however you ought to consult with your institution's legal or compliance officer.

I highly recommend the reference I mentioned above. You wouldn't believe the complexity of the interpretations for these codes and Padgett points out instances where CAP's interpretation disagrees with AMA's.  Padgett devotes 21 pages of discussion on FNA coding

Vinnie Della Speranza

Manager for Anatomic Pathology Services

165 Ashley Avenue Suite 309

Charleston, SC 29425

tel. 843-792-6353

fax. 843-792-8974

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Mary McCoy
Sent: Thursday, December 31, 2009 10:23 AM
To: DKBoyd <@t> chs.net; histonet-bounces <@t> lists.utsouthwestern.edu; Carolyn Demarinis
Cc: HISTONET <@t> PATHOLOGY.SWMED.EDU
Subject: Re: [Histonet] FNA code

There is no Technical component to 88173, so how do you charge for the technical preparation of the ThinPrep?

Mary McCoy HTL(ASCP)

Supervisor of Pathology Services

Lakeland Regional Health System

St. Joseph MI 49098

(269) 982-4891

mmccoy <@t> lakelandregional.org

>>> <DKBoyd <@t> chs.net> 12/30/2009 9:42 AM >>>

88173

Debbie M. Boyd, HT(ASCP) l Chief Histologist l Southside Regional Medical

Center I

200 Medical Park Boulevard l Petersburg, Va.  23805 l T: 804-765-5050 l F:

804-765-5582 l dkboyd <@t> chs.net

"Demarinis, Carolyn" <cdemarinis <@t> SARATOGACARE.ORG>

Sent by: histonet-bounces <@t> lists.utsouthwestern.edu

12/30/2009 08:18 AM

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Subject

[Histonet] FNA code

Which CPT code are labs using for fine needle aspirations that are

processed using thinprep technique -

FNA interpretation and report-88173 or

thinprep non-gyn 88112?  Thank you.

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