Correct CPT Coding for the 88160 Family

July 13, 2012

Code 88160 - Cytopathology, smears, “any other source”; screening and interpretation Code 88161 - Cytopathology, smears, any other source; preparation, screening and interpretation

Code 88162 - Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains.

To code correctly for code family 88160-88162, you need to understand what is meant by “any other source” and to do that, you need to go back and look at cytopathology codes 88104, 88108 and 88112.

• Code 88104 is reported for fluids, washings or brushings, except cervical or vaginal; smears with interpretation.

• Code 88108 is reported for concentration technique; smears with interpretation.

• Code 88112 is reported for selective cellular enhancement techniques with interpretation.

“Any other source” in the 88160 family means samples (Cell source) that are non-gyn or non- fluids/washings/brushings in origin. Some of the most common would be smears from sputum or nipple secretions. If the sample received as a slide is “other than fluids, washings or brushings,” such as sputum, then 88160 would be reported. Commonly, sputum samples are evaluated using either the concentration technique or thin prep method. If so, then report the appropriate code for the service.

If sputum/discharge smears are submitted and five or more slides and/or multiple stains are done, then 88162 (Cytopathology, smears, any other source: extended study) would be reported. However, if a specimen received involves multiple direct smears from a bronchial brushing, the appropriate code is 88104 (Cytopathology, fluids, washings or brushings, except cervical or vaginal: smears with interpretation).

Although the definitions for codes 88104 and 88162 can encompass multiple smears; it is the source of the specimen that differentiates between the codes. Code 88162 applies to specimens in the 88160 family only; therefore, it is for use with limited cytopathology smear only.

To summarize, because the 88160 family specifically excludes the preceding cell sources of fluids/washings/brushings and vaginal/cervical, these cases should not be coded using 88162, regardless of the number of smears or stains. This would also include Pap smears and sources, such as plural fluids or bronchial washings. In addition, code 88162 is not used for other cell studies requiring multiple stains or slides such as Fine Needle Aspirates Smears, which is reported with code 88173 or Bone Marrow Aspirate Smears, which is reported with code 85097.