Summary & Overview
CPT 88314: Special Stain Interpretation on Frozen Tissue Block
CPT code 88314 represents the special stain procedure, including interpretation and report, for histochemical stains on frozen tissue blocks. This code is a critical component of surgical pathology, enabling pathologists to identify specific cellular features and disease markers that are not visible with standard staining techniques. The procedure is typically performed in laboratory settings and is essential for diagnosing a range of conditions, including various neoplasms and melanomas.
Major national payers covering this code include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a comprehensive overview of payer coverage, billing practices, and clinical context for 88314. Readers will gain insights into current policy updates, reimbursement benchmarks, and the role of special stains in surgical pathology. The analysis also highlights relevant modifiers and associated taxonomies, offering a clear understanding of how this code fits into broader laboratory medicine and pathology workflows.
This summary serves as a resource for healthcare professionals, laboratory administrators, and policy analysts seeking to understand the national landscape for CPT code 88314, including payer coverage, clinical applications, and billing considerations.
CPT Code Overview
CPT code 88314 is used to report a special stain procedure, including interpretation and report, specifically for a histochemical stain performed on a frozen tissue block. This code is listed separately in addition to the code for the primary procedure. The service falls under surgical pathology procedures and is typically performed in a laboratory setting (Place of Service 81). Special stains are essential for identifying specific cellular components or microorganisms, aiding in accurate diagnosis and treatment planning.
Clinical & Coding Specifications
Clinical Context
A patient presents with a suspicious skin lesion, and a surgical excision is performed. During the procedure, a frozen tissue block is prepared in the laboratory for immediate evaluation. To aid in diagnosis, a histochemical special stain is applied to the frozen tissue block. The pathologist interprets the stained slide and provides a report, which assists in determining the nature of the lesion, such as distinguishing between benign and malignant neoplasms or identifying melanoma. This workflow is typical in surgical pathology when rapid intraoperative decisions are needed.
Coding Specifications
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Modifier
26: Used to indicate the professional component, which covers the pathologist's interpretation and report of the special stain. -
Modifier
TC: Used to indicate the technical component, which covers the laboratory's performance of the special stain on the frozen tissue block.
| Modifier Code | Description |
|---|---|
26 | Professional Component |