Clinical Context
A dermatopathology laboratory receives a skin biopsy specimen processed onto glass slides with hematoxylin and eosin stains and additional immunofluorescent stains. A dermatopathology technologist performs whole-slide image scanning to create high-resolution digital images for immediate review by a pathologist and for archiving. The workflow: tissue accessioning and slide labeling → immunofluorescent staining reported under +88350 (one unit per additional immunofluorescent antibody stain) → clinical staff triggers scanning for digital review → technologist uses a validated whole-slide scanner to capture, QC, and store the digitized images → pathologist reviews the digital images for diagnostic interpretation. Typical site of service is an independent or hospital-based pathology laboratory or outpatient surgical pathology/dermatopathology practice. A typical patient scenario: an outpatient with a suspicious blistering skin disorder or cutaneous neoplasm has a punch or excisional biopsy; the lab performs H&E and an additional immunofluorescent antibody stain; technologist digitizes the immunofluorescence slide(s) and reports scanning activity with add-on code +0846T (one unit per +88350 unit) to document clinical staff time and scanning for immediate or deferred pathologic diagnosis.
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|
L20.9 | Atopic dermatitis, unspecified | Biopsies for inflammatory dermatoses may require immunofluorescence and digital scanning to evaluate immune complex deposition. |
L95.9 | Purpura and other hemorrhagic conditions, unspecified | Evaluation for vasculitis or immune-mediated skin disease often uses direct immunofluorescence, with slides digitized for interpretation.
L11.0 | Bullous pemphigoid | Autoimmune blistering diseases commonly require immunofluorescent studies and digitization of slides for diagnosis and consultation.
C44.91 | Squamous cell carcinoma of skin, unspecified site | Cutaneous malignancies biopsied and processed with ancillary stains may have slides digitized for diagnostic archiving and consultation.
D48.5 | Neoplasm of uncertain behavior of skin | Ambiguous lesions often require additional staining and digital review as part of pathology workflow.
Z85.820 | Personal history of malignant melanoma of skin | Surveillance biopsies and correlated immunofluorescent/IHC studies may be digitized for comparison and consultation.
R22.9 | Localized swelling, mass and lump, unspecified | Biopsied masses of the skin requiring special stains and digital imaging for definitive pathologic diagnosis.
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|
+88350 | Immunofluorescent antibody stain, each additional antibody (List separately in addition to code for primary stain) | +0846T is reported one unit for digitizing slides for each unit of +88350; the add-on documents clinical staff scanning of immunofluorescence slides. |
88342 | Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain | Often performed alongside immunofluorescence studies; scanned slides for IHC may be included in digital workflow though +0846T specifically ties to +88350 units.
88305 | Level IV surgical pathology, gross and microscopic examination | Primary surgical pathology interpretation code for biopsy specimens; whole-slide scanning supports the pathologist's microscopic review and may be used in the diagnostic workflow prior to or during interpretation.
88331 | Pathology consultation during surgery (intraoperative consultation), with frozen section(s) | Frozen sections and intraoperative consultations may also utilize rapid digitization workflows; +0846T documents formal scanning for later review rather than intraoperative frozen interpretation.
88300 | Level I surgical pathology, gross and microscopic examination (eg, single small biopsy) | Smaller specimen pathology codes frequently precede additional special stains and digitization; +0846T applies when slides produced from these specimens are digitized.