How To Use CPT Code 88377

CPT 88377 describes the process of morphometric analysis using in situ hybridization (ISH) with a multiplex probe stain. 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 88377?

CPT 88377 can be used to describe the morphometric analysis performed using in situ hybridization (ISH) with a multiplex probe stain. This code is used when a qualified provider, typically a pathologist, evaluates stained slides prepared from a single patient specimen, such as tumor tissue, and manually counts or estimates the number and location of probes.

2. Official Description

The official description of CPT code 88377 is: ‘Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure.’

3. Procedure

1. The lab analyst prepares stained slides from the patient specimen, such as tumor tissue, using the in situ hybridization (ISH) technique with a multiplex probe stain.
2. The pathologist evaluates the stained slides under a microscope and manually counts or estimates the number and location of probes.
3. The pathologist may also perform morphometric analysis, which involves interpreting the findings and reaching a pathologic diagnosis based on the probe count or a semiquantitative value.
4. The pathologist prepares a report for the ordering clinician, summarizing the findings and their clinical significance.

4. Qualifying circumstances

CPT 88377 is used for morphometric analysis performed using in situ hybridization (ISH) with a multiplex probe stain. This procedure is typically performed to aid in the diagnosis of certain cancers, such as breast or cervical cancers. It allows the clinician to detect, localize, and enumerate a gene of interest in the patient specimen, providing valuable information for diagnosis and treatment planning. The procedure should be performed by a qualified provider, such as a pathologist, who is approved by payers to interpret the ISH test.

5. When to use CPT code 88377

CPT code 88377 should be used when a qualified provider performs morphometric analysis using in situ hybridization (ISH) with a multiplex probe stain. This code is appropriate for quantitative or semi-quantitative evaluation of the probe stain, where the provider manually counts or estimates the number and location of probes. If the procedure does not involve quantitative or semiquantitative evaluation, other codes in the range 88364 to 88366 should be used instead.

6. Documentation requirements

To support a claim for CPT 88377, the following documentation is required:

• Identification of the patient specimen, such as tumor tissue
• Description of the in situ hybridization (ISH) technique used, including the multiplex probe stain
• Date of the procedure
• Start and end time of the procedure
• Results of the morphometric analysis, including the probe count or semiquantitative value
• Pathologic diagnosis based on the analysis
• Signature of the qualified provider who performed the analysis

7. Billing guidelines

When billing for CPT 88377, ensure that the procedure is performed by a qualified provider, such as a pathologist, who is approved by payers to interpret the ISH test. If the provider only performs the technical work to prepare the slides, append modifier TC (Technical Component) to the code. If the provider only performs the professional work to interpret and report on the slides, append modifier 26 (Professional Component) to the code. If both the technical and professional components are performed by the same provider, the code can be reported without a modifier.

8. Historical information

CPT 88377 was added to the Current Procedural Terminology system on January 1, 2015. There have been no updates to the code since its addition.

9. Examples

1. A pathologist performing morphometric analysis using in situ hybridization (ISH) with a multiplex probe stain on tumor tissue to detect and enumerate a gene of interest.
2. A pathologist manually counting the number of probes in stained slides prepared from a patient specimen to aid in the diagnosis of breast cancer.
3. A pathologist estimating the location of probes in stained slides from cervical cancer tissue to determine the extent of the disease.
4. A pathologist performing morphometric analysis on multiplex probe stained slides to assess the response to treatment in a patient with lung cancer.
5. A pathologist interpreting the results of a multiplex probe stain to guide the selection of targeted therapy for a patient with ovarian cancer.
6. A pathologist performing morphometric analysis on ISH stained slides to differentiate between different subtypes of lymphoma in a patient.
7. A pathologist manually counting the number of probes in stained slides from a patient specimen to assess the prognosis of colorectal cancer.
8. A pathologist estimating the semiquantitative value of probes in ISH stained slides to determine the aggressiveness of prostate cancer.
9. A pathologist performing morphometric analysis on multiplex probe stained slides to identify genetic mutations in melanoma tissue.
10. A pathologist interpreting the results of a multiplex probe stain to determine the HER2 status in breast cancer tissue.