2025 CPT code 88188
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Cytopathology Procedures Pathology and Laboratory Feed
Interpretation of flow cytometry results; 9 to 15 markers.
Modifiers may be applicable depending on the circumstances of service. Consult the CPT manual and payer-specific guidelines for appropriate modifier usage.
Medical necessity for this code is established when flow cytometry is indicated for the diagnosis, monitoring, or staging of various hematologic malignancies, as well as for the evaluation of other conditions with distinct immunophenotypic profiles. It's crucial to have clear clinical documentation supporting the need for the procedure and correlating the results with the patient's clinical presentation.
The pathologist reviews and evaluates the flow cytometry results, providing an interpretation of the clinical significance of the findings.This includes correlating the results with the patient's clinical history and other diagnostic information.
In simple words: This code covers a doctor's (usually a pathologist) interpretation of a lab test called flow cytometry. This test uses lasers to look at cells and find out if there are any problems, like cancer. The doctor looks at the results from the test that shows 9 to 15 different parts of the cell, and explains what it means for the patient's health.
This CPT code, 88188, represents the professional interpretation of flow cytometry results involving the analysis of 9 to 15 markers.Flow cytometry is a laboratory technique that uses lasers and light scattering to identify and quantify cells based on their specific surface markers or intracellular components. The interpretation involves a pathologist's comprehensive review and evaluation of the flow cytometry data to determine the clinical significance of the findings, which may include identifying malignancies such as leukemia or lymphoma.
Example 1: A patient presents with suspected acute lymphoblastic leukemia (ALL). A flow cytometry panel is ordered, analyzing 12 markers to identify the specific leukemia subtype and determine the extent of disease., A patient with a history of lymphoma undergoes a follow-up flow cytometry study post-chemotherapy.The analysis of 10 markers helps assess the effectiveness of treatment and detect any residual disease., A patient presents with unexplained cytopenias (low blood cell counts).A flow cytometry panel, examining 15 markers, is used to evaluate for bone marrow disorders, such as aplastic anemia or myelodysplastic syndrome.
* Patient's clinical history and presenting symptoms.* Complete laboratory requisition and test orders.* Detailed flow cytometry report generated by the laboratory.* Pathologist's interpretation and report, including the number of markers analyzed and the clinical significance of the results.* Supporting diagnostic studies (e.g., peripheral blood smear, bone marrow biopsy) relevant to the clinical context.
** Always ensure proper documentation to support medical necessity.The number of markers should be accurately documented in the laboratory report and the pathologist's interpretation.Compliance with local coverage determinations (LCDs) is crucial for reimbursement.
- Revenue Code: T1G (LAB TESTS - OTHER)
- RVU: The RVUs for this code vary depending on the geographic location and payer. Consult your local Medicare fee schedule or payer-specific guidelines for the most up-to-date information.
- Payment Status: Active
- Modifier TC rule: Modifier -26 (professional component) is not required.
- Fee Schedule: Historical fee schedule data is not readily available.Refer to publicly available fee schedules from CMS or your specific payer.
- Specialties:Hematology, Oncology, Pathology
- Place of Service:Office, Hospital, Laboratory