Coding Corner

Q. We received a lung wedge biopsy and processed it in multiple blocks A1-A5.  We performed acid fast bacilli stain on block A1 and A2 and a gram stain on block A3.  Can we report 88312 x 3?  

A. Yes you can. The AMA’s CPT revised the special stain codes in 2012 for better definition and to facilitate reporting of these services.  The CPT code descriptors and notes now clarify that you do report special stains once for each stain performed on each surgical block, cytologic specimen or hematologic smear:

88312 Special stain including interpretation and report; Group I for microorganisms
(Report one unit of 88312 for each special stain, on each surgical pathology block, cytologic specimen, or hematologic smear)

88313 Group II, all other, except stain for microorganisms, stains for enzyme constituents, or    immunocytochemistry and immunohistochemistry
(Report one unit of 88313 for each special stain, on each surgical pathology block, cytologic specimen, or hematologic smear)

88319 Group III, for enzyme constituents
(For each stain on each surgical pathology block, cytologic specimen, or hematologic smear, use one unit of 88319)

Q.  I have a surgical report for a colon resection and the final diagnosis is diverticulosis with diverticulitis.  What diagnosis would I assign for this?

A. Per 2013 ICD-9-CM, you would assign code 562.11 (diverticulosis, colon with diverticulitis).   Looking ahead to ICD-10 it will become more detailed as reporting diverticular disease of the intestine expands from 8 code choices to 24, relying on  documentation within the report to determine the final code depending on location,  involvement of small or large intestine (or both), and complication(s) such as  perforation, abscess, or bleeding.