Demystifying CPT and HCPCS Codes in Clinical Pathology Lab Medical?Billing

CPT and HCPCS Codes in Clinical Pathology

Current Procedural Terminology (CPT) codes are essential for the healthcare industry because they are a cornerstone for medical billing and documentation processes. They serve as a universal language that healthcare providers, insurers providers, and government agencies understand. These codes provide a standardized way to describe medical procedures and services. These codes help ensure that healthcare services are accurately documented, billed, and compensated. Some key CPT codes for clinical pathology labs are mentioned below.

Key CPT Codes in Clinical Pathology labs

CPT Code 88302: This code is for a level II examination of a surgical pathology specimen. It involves examining the gross and microscopic features of the specimen and reporting the findings.

CPT Code 88305: This code is used for a level IV examination of a surgical pathology specimen. It involves examining both the gross and microscopic features of the specimen and reporting the findings.

CPT Code 88309: This code is used for a level VI examination of a surgical pathology specimen. It involves accessioning the specimen into the lab. This includes formally receiving the specimen and then examining the gross and microscopic features of the specimen before reporting the findings.

CPT Code 81228: This code is related to a laboratory test using comparative genomic hybridization (CGH) microarray. This is also known as chromosomal microarray (CMA). It is used to detect variations in the number of copies of gene sequences that are known as copy-number variants (CNVs).

CPT Code +88350: This code is for an immunofluorescent study that uses a single antibody stain procedure to detect autoimmune diseases. This can also be used to detect the infectious organisms in a tissue or cellular sample. It typically follows an initial stain with a different antibody.

CPT Code 88172: This code is used when a lab analyst performs a technical test to analyze a cytopathology specimen from a fine needle aspirate. This code represents that all procedures have been done immediately. It is used to determine whether a satisfactory sample for diagnosis was obtained.

CPT Code 88311: This code deals with the decalcification procedure performed on a specimen. The purpose of this procedure is to dissolve calcium in the specimen because it helps make it easier to perform specific examinations.

CPT Code 88329: This code is used for consultation during surgery, where a pathologist assists the surgeon in evaluating a specimen on a course of action.

CPT Code 88312: This code is used for technical lab steps. The purpose of this code is to stain a specimen with a special stain, typically for microorganisms concerning Group I. A pathologist typically interprets the slide and issues a report.

Key HCPCS Codes for Clinical Pathology Labs Procedures

Below are the common HCPCS codes for clinical pathology labs.

P2028: This code is used for examining Cephalin flocculation, Blood

P2029: This code is used for examining Congo red, Blood

P2031: This code is used for examining Hair analysis (excluding arsenic)

P2033: This code is used for examining Thymol turbidity, Blood

P2038: This code is used for examining Mucoprotein, blood (seromucoid) (medical necessity procedure)

P9010: This code is used for examining Blood (whole), for transfusion, per unit

P9016: This code is used for examining Red blood cells, leukocytes are reduced, each unit

P9019: This code is used for Platelets. Each unit

P9020: This code is used for Platelet-rich plasma; each unit

P9021: This code is used for Red blood cells, each unit

P7001: This code is used for Culture, bacterial, urine, quantitative, and sensitivity study

These codes help healthcare providers bill for various laboratory tests and procedures. These codes ensure accurate documentation and reimbursement for their services.

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