Summary & Overview
CPT 0846T: Digital Pathology Slide Scanning and Digitization
CPT code 0846T represents clinical staff time to scan and digitize whole–slide images from glass microscope slides for immediate or later pathologic diagnosis. As an add–on code, 0846T is reported per unit of digitization and is intended to be billed alongside the primary pathology service it supports, such as additional immunofluorescent antibody staining. The code reflects the increasing adoption of digital pathology workflows that enable remote review, image archiving, and integration with digital diagnostic tools.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code’s clinical context and service settings, typical billing considerations, and guidance on related reporting (where available). The publication summarizes national relevance as digital pathology expands across hospital and independent laboratory settings, affecting coding practices and operational workflows.
The report provides benchmarks and policy summaries where available, explains the relationship between 0846T and associated pathology procedure codes, and outlines common use cases in diagnostic laboratories. Data not available in the input is noted where appropriate.
Billing Code Overview
CPT code 0846T describes clinical staff work to scan and digitize whole–slide images from glass microscope slides for immediate or later pathologic diagnosis. The code is an add–on code reported per unit of digitization performed to accompany an associated pathology service.
Service type: Digital pathology slide scanning and digitization performed by clinical staff
Typical site of service: Hospital pathology laboratories and independent diagnostic pathology labs
Clinical & Coding Specifications
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.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when scanning required substantially greater clinical staff time or complexity than typical, with documentation of rationale and additional work performed for digitization. |
52 | Reduced services | Use when the scanning service is partially performed or curtailed (for example, incomplete digitization due to equipment limitations) and billed at a reduced level.
53 | Discontinued procedure | Use when scanning was started but terminated due to unforeseen circumstances (e.g., slide damage) and documentation supports discontinuation.
59 | Distinct procedural service | Use when it is necessary to indicate the scanning add-on is a distinct service from other reported pathology procedures (apply per payer guidance).
76 | Repeat procedure by same provider | Use when the whole-slide scanning was repeated by the same facility/provider during the same encounter.
77 | Repeat procedure by another provider | Use when another facility/provider repeats the digitization after initial scanning.
LT | Left side | Rarely applicable; use when laterality reporting is relevant for the specimen (per payer rules).
RT | Right side | Rarely applicable; use when laterality reporting is relevant for the specimen (per payer rules).
JW | Drug wastage not applicable but often listed for lab add-ons | Not typically used for scanning; include only if payer requires for bundled services (document rationale).
95 | Synchronous telemedicine service rendered via real-time interactive audio and video | Use when digitized slide review occurs in real time as part of an interactive telepathology consultation.
| Taxonomy Code | Specialty | Notes |
|---|---|---|
261QM0800X | Pathology | Clinical and anatomic pathologists oversee slide preparation and digital sign-out workflows. |
207L00000X | Dermatology | Dermatologists submit skin biopsy specimens and coordinate diagnostic testing.
174400000X | Diagnostic Laboratory | Laboratory technologists and histotechnologists perform scanning and image preparation.
2085R0201X | Dermatopathology | Subspecialty pathologists interpret dermatopathology digital images.
3336C0002X | Telepathology Services | Providers involved in remote digital slide review and telemedicine sign-out.
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.