How To Use CPT Code 88355

CPT 88355 describes the morphometric analysis of skeletal muscle, which involves evaluating the size, shape, and other physical features of skeletal muscle. 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 88355?

CPT 88355 is used to describe the morphometric analysis of skeletal muscle. This procedure involves a qualified provider, typically a pathologist, evaluating the physical features of skeletal muscle, such as muscle fiber type, area, size, capillary density, and cellular appearance. The analysis is performed after a lab analyst prepares slides and stains the specimens collected by biopsy.

2. Official Description

The official description of CPT code 88355 is: ‘Morphometric analysis; skeletal muscle.’

3. Procedure

1. After a lab analyst prepares slides, the qualified provider, usually a pathologist, performs a morphometric analysis of skeletal muscle.
2. The provider evaluates the size, shape, and other physical features of the skeletal muscle, including muscle fiber type, area, size, capillary density, and cellular appearance.
3. The analysis can be done manually with microscopy or using automated methods.
4. The procedure may be ordered by a clinician to distinguish normal from abnormal skeletal muscle, such as in cases of Duchenne muscular dystrophy.

4. Qualifying circumstances

CPT 88355 is typically performed by a pathologist or a qualified provider who has expertise in evaluating skeletal muscle. The procedure is ordered to assess the physical features of skeletal muscle and is not limited to specific conditions. It may be used to distinguish normal from abnormal muscle in cases such as Duchenne muscular dystrophy.

5. When to use CPT code 88355

CPT code 88355 should be used when a qualified provider performs a morphometric analysis of skeletal muscle to evaluate its physical features. It is appropriate to use this code when assessing muscle size, shape, fiber type, area, capillary density, and cellular appearance. This code should not be used for other types of tissue analysis or for different anatomical structures.

6. Documentation requirements

To support a claim for CPT 88355, the documentation should include:

• Indication for the morphometric analysis of skeletal muscle
• Details of the analysis performed, including the physical features evaluated
• Method used for the analysis (manual or automated)
• Results of the analysis, including any abnormalities or distinguishing features
• Signature of the qualified provider who performed the analysis

7. Billing guidelines

When billing for CPT 88355, ensure that the procedure is performed by a qualified provider, typically a pathologist. It is important to accurately document the analysis and its results. CPT code 88355 should not be reported with other codes unless there are separate and distinct services performed. It is essential to follow the specific guidelines provided by the payer to ensure proper reimbursement.

8. Historical information

CPT 88355 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A pathologist performing a morphometric analysis of skeletal muscle to evaluate the size and shape of muscle fibers in a patient with suspected muscular dystrophy.
2. An expert provider assessing the capillary density and cellular appearance of skeletal muscle in a research study on exercise-induced adaptations.
3. A pathologist analyzing the area and size of muscle fibers in a biopsy sample to determine the severity of muscle wasting in a patient with a neuromuscular disorder.
4. A qualified provider evaluating the muscle fiber type and capillary density in skeletal muscle to differentiate between normal and abnormal muscle in a patient with unexplained muscle weakness.
5. A pathologist performing a morphometric analysis of skeletal muscle to assess the cellular appearance and size variation in a patient with suspected inflammatory myopathy.
6. An expert provider analyzing the capillary density and area of muscle fibers in skeletal muscle to study the effects of aging on muscle structure.
7. A pathologist evaluating the size and shape of muscle fibers in a biopsy sample to determine the presence of muscle atrophy in a patient with prolonged immobilization.
8. A qualified provider assessing the muscle fiber type and area in skeletal muscle to investigate the effects of a new exercise regimen on muscle hypertrophy.
9. A pathologist performing a morphometric analysis of skeletal muscle to evaluate the cellular appearance and capillary density in a patient with suspected mitochondrial myopathy.
10. An expert provider analyzing the size and shape of muscle fibers in skeletal muscle to assess the effects of a specific medication on muscle structure in a clinical trial.