How To Use CPT Code 88363

CPT 88363 describes the examination and selection of previously diagnosed tissue for molecular analysis. 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 88363?

CPT 88363 can be used to describe the technical steps performed by a pathologist to examine and select archived tissue for molecular analysis. This code applies to the examination and selection of one or more tissues that have been previously diagnosed and stored. The purpose of this procedure is to identify any mutations or alterations in the DNA sequence that may lead to pathologic changes in the organism.

2. Official Description

The official description of CPT code 88363 is: ‘Examination and selection of retrieved archival (i.e., previously diagnosed) tissue(s) for molecular analysis (e.g., KRAS mutational analysis).’ This code applies to the examination and selection of one or more tissues that have been previously diagnosed and stored for molecular analysis.

3. Procedure

1. A pathologist reviews the original case report and identifies the need for molecular analysis of the archived tissue.
2. The pathologist prepares a block or slide containing the appropriate tumor tissue, slides, or paraffin blocks from the previously completed and stored specimen.
3. The pathologist examines the tissue and selects a sample for molecular analysis, such as KRAS mutational analysis.
4. The selected tissue sample is then sent for further molecular analysis to identify any mutations or alterations in the DNA sequence.

4. Qualifying circumstances

CPT 88363 is performed by a pathologist on previously diagnosed tissue that has been stored for molecular analysis. This code is used when the pathologist examines and selects tissue samples for further molecular analysis, such as KRAS mutational analysis. It is important to note that this code should not be used if the pathologist or treating physician decides to prepare tissue for molecular testing before the primary case is completed and signed out.

5. When to use CPT code 88363

CPT code 88363 should be used when a pathologist performs the examination and selection of previously diagnosed tissue for molecular analysis. This code applies to the technical steps involved in selecting tissue samples for further molecular analysis, such as KRAS mutational analysis. It is important to ensure that the tissue being examined and selected has been previously diagnosed and stored for molecular analysis.

6. Documentation requirements

To support a claim for CPT 88363, the pathologist must document the following information:

• Original case report and the need for molecular analysis of the archived tissue
• Details of the tissue examined and selected for molecular analysis
• Date of the procedure
• Any additional relevant information, such as the specific molecular analysis being performed
• Signature of the pathologist performing the procedure

7. Billing guidelines

When billing for CPT 88363, ensure that the procedure is performed by a pathologist on previously diagnosed tissue for molecular analysis. It is important to follow the guidelines and not use this code if the tissue is being prepared for molecular testing before the primary case is completed and signed out. Additionally, consider any specific billing requirements or modifiers that may be necessary for accurate reimbursement.

8. Historical information

CPT 88363 was added to the Current Procedural Terminology system on January 1, 2011. There have been no updates to the code since its addition.

9. Examples

1. A pathologist examines and selects previously diagnosed tissue for KRAS mutational analysis.
2. A pathologist reviews the original case report and prepares a block of tissue for further molecular analysis.
3. A pathologist selects slides containing tumor tissue for molecular analysis.
4. A pathologist examines and selects paraffin blocks of tissue for molecular analysis.
5. A pathologist identifies the need for molecular analysis and selects multiple tissue samples for further testing.
6. A pathologist reviews the original case report and selects tissue samples for molecular analysis of specific mutations.
7. A pathologist examines and selects archived tissue for molecular analysis to determine the presence of genetic alterations.
8. A pathologist prepares slides containing tumor tissue for molecular analysis of specific gene mutations.
9. A pathologist selects paraffin blocks of tissue for molecular analysis to identify potential pathologic changes.
10. A pathologist reviews the original case report and selects multiple tissue samples for molecular analysis of various mutations.