(2022) How To Bill Surgical Pathology – CPT Code Descriptions & Billing Guidelines
Surgical pathology can be billed with CPT 88367, CPT 88368, CPT 88369, CPT 88373, CPT 88374 & CPT 88377. Underneath the billing guidelines and descriptions of the procedure codes.
Billing Guidelines
The guidelines will require pathologist/laboratories to clearly document when a multiplex/cocktail stained probe procedure has been performed for morphometric analysis by in situ hybridization.
Unit of service for morphometric analysis by in situ hybridization is per specimen, per separate single probe stain procedure.
The terms “single probe stain procedure” and “multiplex probe stain procedure” will play a vital part in the units of service as well as the CPT code that are is selected.
Using the term single probe stain procedure indicates that the same probe that may contain multiple different antibodies on that probe must be assigned the code associated with multiplex probe stain procedure.
It is the procedure that also determines the unit of service of that multiplex probe stain. If the probe(s) are performed in one single stain procedure, then you must consider that one unit of service for that multiplex probe.
For example: if a morphometric analysis by in situ hybridization is performed with a dual probe containing two different antibodies on that single probe, reported in semi/quantitative value…that is one unit of service of CPT 88374 or CPT 88377 (depending on semi/quantitative–manual versus computer assisted).
CPT Codes For Surgical Pathology
Use CPT 88367 or CPT 88368 (semi/quantitative, depending on manual versus computer assisted) for the first single probe stain procedure.
Use CPT 88373 or CPT 88369 for semi/quantitative depending on manual or computer assisted for each additional single probe stain procedure.
Use CPT 88374 or CPT 88377 for multiplex staining procedures:semi/quantitative (depending on manual versus computer assisted) when multiple antibodies on a probe by a single staining procedure.
88367 CPT Code Description
CPT 88367 can be used to bill each probe for morphometric analysis in situ hybridization. It is defined as:
“Morphometric analysis. Each probe. In situ hybridization. Semi quantitative or quantitative.”
88368 CPT Code Description
CPT 88368 can be used to bill morphometric analysis in situ hybridization as well. It is used to describe the initial single probe stain procedure and is defined as:
“Morphometric analysis, in situ hybridization. Manual. Semi quantitative or quantitative. Per specimen. Initial single probe stain procedure.”
88369 CPT Code Description
CPT 88369 is an add-on code and has to be billed in conjunction with CPT 88368. It is defined as:
“Morphometric analysis in situ hybridization. Each additional single probe stain procedure. Semi quantitative or quantitative. Per specimen. Manual.”
88373 CPT Code Description
CPT 88373 is an add-on code for CPT 88367 and can only be billed in conjuction with the primary code. It is defined as: “Each additional single probe stain procedure. Morphometric analysis in situ hybridization using computer assisted technology. Semi quantitative or quantitative. Per specimen.”
88374 CPT Code Description
CPT 88374 can be billed for morphometric analysis in situ hybridization and is defined as: “Morphometric analysis in situ hybridization. Using computer-assisted technology. Per specimen. Semi quantitative or quantitative. Each multiplex probe stain procedure.”
Do not report CPT 88374 for the same probe in conjunction with:
CPT 88368; and
CPT 88377.
88377 CPT Code Description
CPT 88377 can be used as an add-on code for morphometric analysis in situ hybridization. It is defined as: “Morphometric analysis in situ hybridization. Per specimen. Each multiplex probe stain procedure. Semi quantitative or quantitative. Manual.”
Do not report CPT 88377 for the same probe in conjunction with:
CPT 88365;
CPT 88366;
CPT 88367; or
CPT 88374.
