How To Use CPT Code 89190

CPT 89190 describes the examination of a nasal smear to check for the presence of eosinophils, a type of white blood cell that increases in response to allergies and parasitic infections. 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 89190?

CPT 89190 can be used to describe the examination of a nasal smear to determine the presence of eosinophils. Eosinophils are a type of white blood cell that increases in number in response to allergies and parasitic infections. This code is used when a lab analyst performs the technical steps to examine a nasal smear for eosinophils after a clinician collects a specimen from the patient’s nasopharynx and spreads it onto a glass slide. The analyst then air dries the slide, stains it with Wright stain, and examines it under a microscope for the presence of eosinophils.

2. Official Description

The official description of CPT code 89190 is: ‘Nasal smear for eosinophils.’

3. Procedure

1. A clinician collects a specimen from the patient’s nasopharynx.
2. The clinician spreads the material onto a glass slide.
3. The lab analyst air dries the slide.
4. The analyst stains the slide with Wright stain.
5. The analyst examines the slide under a microscope for the presence of eosinophils.
6. The analyst may report the results as a percentage of eosinophils per 100 white blood cells or as present or not present.

4. Qualifying circumstances

CPT 89190 is used when a clinician orders the examination of a nasal smear to differentiate a sinus infection from an allergic condition. Sinus infections typically demonstrate an increase in infection-fighting neutrophils, while allergies, such as seasonal pollen or hay fever, produce greater numbers of eosinophils. This test is not limited to testing for a specific condition and can be ordered by a clinician based on the patient’s symptoms and medical history.

5. When to use CPT code 89190

CPT code 89190 should be used when a clinician orders the examination of a nasal smear to check for the presence of eosinophils. It is appropriate to use this code when the clinician suspects an allergic condition or needs to differentiate a sinus infection from an allergic condition. This code should not be used for other types of tests or procedures.

6. Documentation requirements

To support a claim for CPT code 89190, the clinician and lab analyst must document the following information:

• Patient’s symptoms and medical history
• Date and time of specimen collection
• Method of specimen collection
• Details of the lab analysis, including the staining method used
• Results of the examination, including the presence or absence of eosinophils
• Signature of the lab analyst performing the examination

7. Billing guidelines

When billing for CPT code 89190, ensure that the examination of the nasal smear for eosinophils is performed by a lab analyst. Use this code only for the specific procedure described and do not report it for other types of tests or procedures. There are no specific guidelines regarding reporting this code with other codes.

8. Historical information

CPT code 89190 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 clinician orders the examination of a nasal smear for eosinophils to differentiate between a sinus infection and an allergic condition in a patient with persistent nasal congestion.
2. A clinician suspects an allergic condition in a patient with recurrent sneezing and itchy eyes, and orders the examination of a nasal smear for eosinophils.
3. A patient presents with symptoms of a sinus infection, and the clinician orders the examination of a nasal smear for eosinophils to confirm the diagnosis.
4. A clinician wants to determine the presence of eosinophils in a patient with a history of allergies and orders the examination of a nasal smear.
5. A patient with chronic sinusitis undergoes a nasal smear examination to check for the presence of eosinophils as part of their diagnostic workup.
6. A clinician orders the examination of a nasal smear for eosinophils in a patient with suspected allergic rhinitis.
7. A patient with a history of parasitic infections undergoes a nasal smear examination to check for the presence of eosinophils.
8. A clinician orders the examination of a nasal smear for eosinophils in a patient with recurrent nasal polyps.
9. A patient with a suspected allergic reaction undergoes a nasal smear examination to determine the presence of eosinophils.
10. A clinician orders the examination of a nasal smear for eosinophils in a patient with chronic rhinosinusitis.