How To Use CPT Code 88311

CPT 88311 describes a decalcification procedure that is performed on a specimen to make it easier to perform certain examinations. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 88311?

CPT 88311 can be used to describe a decalcification procedure performed on a specimen to dissolve the calcium present in it. This procedure is necessary when the specimen, most commonly bone, contains calcium and cannot be thinly sliced for microscopic review. The decalcification process is performed by a lab analyst to prepare the specimen for a separately reported surgical pathology examination.

2. Official Description

The official description of CPT code 88311 is: ‘Decalcification procedure (List separately in addition to code for surgical pathology examination).’ This code is an add-on code and should be reported in addition to an appropriate primary code for the surgical pathology examination.

3. Procedure

1. The lab analyst obtains a specimen, typically bone or any tissue containing calcium.
2. The lab analyst performs a decalcification procedure on the specimen using a mineral acid solution or another suitable solution to dissolve the calcium.
3. The decalcified specimen is then ready for the qualified provider, usually a pathologist, to perform a separately reported surgical pathology examination.

4. Qualifying circumstances

The decalcification procedure, represented by CPT 88311, is performed on any surgical specimen containing calcium prior to pathologic review. It is necessary when the specimen cannot be thinly sliced for microscopic examination due to the presence of calcium. The procedure is typically performed by a lab analyst, and the resulting decalcified specimen is then used for a surgical pathology examination.

5. When to use CPT code 88311

CPT code 88311 should be used when a decalcification procedure is performed on a specimen containing calcium to prepare it for a surgical pathology examination. It is important to note that this code is an add-on code and should be reported in addition to an appropriate primary code for the surgical pathology examination.

6. Documentation requirements

To support a claim for CPT 88311, the following documentation is required:

• Identification of the specimen and the need for decalcification
• Description of the decalcification procedure performed
• Date of the procedure
• Signature of the lab analyst performing the procedure

7. Billing guidelines

When billing for CPT 88311, ensure that the procedure is performed by a lab analyst and that it is reported in addition to an appropriate primary code for the surgical pathology examination. Payers may not reimburse for CPT 88311 if it is not reported with the primary code. It is important to follow the specific guidelines provided by the payer regarding the reporting of add-on codes.

8. Historical information

CPT 88311 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs a decalcification procedure on a bone specimen before it is examined by a pathologist.
2. A calcified tumor specimen is decalcified by a lab analyst to prepare it for a surgical pathology examination.
3. A bone specimen containing calcium is subjected to a decalcification procedure by a lab analyst to enable microscopic review by a pathologist.
4. A lab analyst uses a mineral acid solution to dissolve the calcium in a bone specimen, allowing for a surgical pathology examination.
5. A specimen with calcium is decalcified by a lab analyst to facilitate the analysis by a pathologist.