How To Use CPT Code 88312

CPT 88312 is a special stain code for microorganisms, including interpretation and report. This article will cover the description, procedure, qualifying circumstances, when to use, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT code 88312 procedures.

1. What is CPT 88312?

CPT 88312 is a code used to describe a special staining procedure for microorganisms, which includes the interpretation and report of the results. This code is specifically applicable to Group I microorganisms and is used by medical professionals to identify organisms that do not stain with routine stains.

2. 88312 CPT code description

The official description of CPT code 88312 is: “Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver)”.

3. Procedure

The 88312 CPT code procedure involves the following steps:

1. The clinician obtains a specimen from the patient.
2. The lab analyst performs all technical steps to stain the specimen slide with a special Group I stain for microorganisms.
3. The slide is treated with a specific staining process, such as acid fast staining or methenamine silver staining, depending on the microorganism being identified.
4. A qualified provider, typically a pathologist, interprets the stained slide and issues a report on the findings.

4. Qualifying circumstances

Individuals eligible to receive CPT code 88312 services are those who require identification of microorganisms that do not stain with routine stains. This may include patients with suspected infections caused by organisms such as Mycobacterium or certain fungi. The decision to use this code is typically made by the treating clinician based on the patient’s clinical presentation and the need for accurate identification of the causative organism.

5. When to use CPT code 88312

It is appropriate to bill the 88312 CPT code when a special stain is required to identify a Group I microorganism that does not stain with routine stains. This may be necessary in cases where the clinician suspects an infection caused by an organism that is difficult to identify using standard staining techniques, such as Mycobacterium or certain fungi.

6. Documentation requirements

To support a claim for CPT 88312, the following information should be documented:

• The source of the specimen and the method used to obtain it.
• A description of the special staining procedure performed, including the specific stain used (e.g., acid fast or methenamine silver).
• The interpretation and report of the stained slide, including the identification of the microorganism and any relevant clinical findings.
• The rationale for using the special stain, including the clinical presentation and suspected infection.

7. Billing guidelines

When billing for CPT code 88312, it is important to follow these guidelines:

• Report one unit of 88312 for each special stain, on each surgical pathology block, cytologic specimen, or hematologic smear.
• Use 0756T in conjunction with 88312 when the digitization of glass microscope slides is performed.
• Review codes 88312 to 88319 to ensure the most appropriate special stain code is chosen for the case.
• Do not report standard stains that are part of routine slide preparation, such as hematoxylin and eosin, as they are included in the surgical pathology or cytology service.

8. Historical information

CPT 88312 was added to the Current Procedural Terminology system on January 1, 1990. There have been several updates to the code since its addition, with the most recent change occurring on January 1, 2012.

9. Similar codes to CPT 88312

Five similar codes to CPT 88312 and how they differentiate are:

• CPT 88313: This code is used for special stains for morphology, such as trichrome or reticulin, rather than microorganisms.
• CPT 88314: This code is used for special stains for enzyme histochemistry, which is a different staining technique than those used for microorganisms.
• CPT 88319: This code is used for special stains not otherwise specified, which may include stains for other purposes or microorganisms not covered by CPT 88312.
• CPT 88318: This code is used for electron microscopy, which is a different diagnostic technique than special staining.
• CPT 88331: This code is used for intraoperative consultation involving a pathologist, which is a separate service from special staining.

10. Examples

Here are 10 detailed examples of CPT code 88312 procedures:

1. A patient with suspected tuberculosis undergoes a bronchoscopy, and a bronchial washing specimen is obtained. The specimen is stained with an acid fast stain to identify Mycobacterium tuberculosis.
2. A skin biopsy is performed on a patient with a suspected fungal infection. The tissue sample is stained with methenamine silver to identify the presence of fungal elements.
3. A sputum sample is collected from a patient with suspected nocardiosis. The sample is stained with an acid fast stain to identify Nocardia species.
4. A patient with a suspected deep fungal infection undergoes a bone marrow biopsy. The specimen is stained with methenamine silver to identify fungal organisms.
5. A lung biopsy is performed on a patient with suspected Pneumocystis pneumonia. The tissue sample is stained with methenamine silver to identify Pneumocystis jirovecii.
6. A patient with a suspected mycobacterial infection undergoes a lymph node biopsy. The specimen is stained with an acid fast stain to identify the presence of Mycobacterium species.
7. A cerebrospinal fluid sample is collected from a patient with suspected cryptococcal meningitis. The sample is stained with methenamine silver to identify Cryptococcus neoformans.
8. A patient with a suspected Actinomyces infection undergoes a surgical drainage of an abscess. The pus sample is stained with an acid fast stain to identify Actinomyces species.
9. A biopsy of a suspected fungal skin infection is performed. The tissue sample is stained with methenamine silver to identify the presence of fungal hyphae and spores.
10. A patient with a suspected mycobacterial lung infection undergoes a transbronchial biopsy. The tissue sample is stained with an acid fast stain to identify the presence of Mycobacterium species.