One of the big changes in 2006 to the Pathology and Laboratory Section in CPT (Current Procedural Terminology) was the addition of code 88333 (Pathology consultation during surgery; cytologic examination [eg. touch prep, squash prep], initial site) and code 88334 (Pathology consultation during surgery; cytologic examination [eg. touch prep, squash prep], each additional site). When an intraoperative consults on touch preps are performed in the surgical theater setting, instead of reporting codes 88161 and 88329 as was the case prior to 2006, both codes are now reported with one code. An example of this would be: The pathologist is called to the surgical setting to consult on a liver biopsy; a touch prep is done on the specimen. The findings and diagnosis is then reported to the surgeon during the procedure. Code 88333 is reported for this service.
If touch preps are performed from multiple sites during a surgical consultation, codes 88333 and 88334 would be reported. Code 88333 for the initial touch prep and one unit of 88334 for each touch prep from additional sites from the same specimen. These codes are to be used similar to frozen section codes (88331-88332). An example of this would be: The pathologist is called to consult on surgical margins of a breast excision. Touch preps are performed on three margins individually identified by orientation. Code 88333 is reported for the first touch prep and 88334 x 2 for the two additional margins.
Performing a touch prep and a frozen section on the same specimen as part of a intraoperative consult is not uncommon. A CPT note confirms that billing for cytology and a frozen section together may be appropriate. If a frozen section and cytologic evaluation is done on the same specimen different site, code 88331 and 88334. Code 88334 is used for the touch prep and not 88333 because the touch prep comes from an “additional site” distinct from the frozen section on the specimen.
Other CPT notes stated are “for percutaneous needle biopsy requiring intraprocedural cytologic exam, use 88333” and also “do not report 88333 and 88334 for a non- intraoperative cytologic exam or fine needle aspirates.” Use 88161 for non-intraoperative touch preps and 88172 for FNA’s.