2025 CPT code 88189
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Cytopathology Procedures Pathology and Laboratory Feed
Interpretation of flow cytometry results with 16 or more markers.
Modifiers may apply depending on the circumstances of service. Consult the AMA CPT manual for details.
Medical necessity for flow cytometry is determined based on clinical suspicion of hematologic malignancies, need for monitoring disease response, or for distinguishing between different types of diseases. This should be documented clearly in the patient's chart.
The pathologist reviews and interprets the flow cytometry data, providing a clinical explanation of the results. This includes identifying cell populations, assessing their proportions, and correlating findings with clinical presentation for diagnosis and management of the patient's condition.
In simple words: This code covers a doctor's review and explanation of a lab test (flow cytometry) that uses lasers to look at cells.The test uses 16 or more special markers to help identify diseases, particularly types of cancer in the blood.
This CPT code, 88189, represents the interpretation of flow cytometry results involving 16 or more markers.Flow cytometry is a laboratory technique that uses lasers and light scatter to identify and quantify cells based on their surface markers. The interpretation involves analyzing the data generated by the flow cytometer to determine the clinical significance of the findings, which may be relevant in diagnosing various conditions, including hematologic malignancies.This interpretation is typically performed by a pathologist.
Example 1: A patient presents with suspected leukemia. A flow cytometry panel with 18 markers is performed to determine the immunophenotype of the leukemic cells. The pathologist interprets the results and provides a report indicating the specific type of leukemia., A patient with a known lymphoma undergoes flow cytometry with a 20-marker panel to monitor disease progression after treatment. The pathologist’s interpretation of the flow cytometry results assesses the minimal residual disease (MRD) and guides further treatment decisions., A bone marrow biopsy is sent for flow cytometry with a 16-marker panel to help in the diagnosis of a suspected myeloproliferative neoplasm. The interpretation aids in differentiation between various subtypes and guides management.
* Patient demographics and relevant clinical history.* Complete details of the flow cytometry panel used (list of markers).* Raw flow cytometry data (FCS files).* Pathologist’s interpretation report with detailed analysis and clinical correlation.* Supporting documentation for medical necessity.
** When reporting this code, ensure accurate documentation of the number of markers used, and that the clinical indication for flow cytometry is clearly established and documented.Local coverage determinations (LCDs) may apply.Consult your payer’s guidelines and local policies for specific billing requirements.
- Revenue Code: T1G (LAB TESTS - OTHER)
- RVU: RVUs vary based on geographic location and payer. Consult a fee schedule for specific values.
- Global Days: Not applicable.
- Payment Status: Active
- Modifier TC rule: Modifier -26 (professional component) is not usually required for this code as the interpretation is considered an integral part of the testing process.
- Fee Schedule: Fee schedules vary by payer and geographic location. Consult appropriate fee schedules for historical data.
- Specialties:Hematology, Oncology, Pathology
- Place of Service:Laboratory, Hospital, Physician's office