2025 CPT code 88368
(Active) Effective Date: N/A Revision Date: N/A Pathology and Laboratory Procedures - Morphometric Analysis, In Situ Hybridization Surgical Pathology Procedures Feed
This CPT code represents the initial single probe stain procedure for morphometric analysis using in situ hybridization (ISH), a quantitative or semi-quantitative manual method performed per specimen.
Modifiers -TC (Technical Component) and -26 (Professional Component) are applicable.Other modifiers may apply depending on the specific circumstances of service.
The medical necessity is determined by the ordering physician's clinical judgment based on the patient's symptoms, history, and other diagnostic findings. ISH is medically necessary when the information obtained is critical for diagnosis, treatment planning (such as targeted therapy selection), prognosis, or monitoring disease progression.
The clinical responsibility is shared between the laboratory technician (technical component) who performs the staining and slide preparation and the pathologist (professional component) who interprets the results and provides the diagnostic report. The ordering physician uses the information to guide patient diagnosis and treatment planning.
- Surgical Pathology Procedures
- Surgical Pathology Procedures; Morphometric Analysis, In Situ Hybridization
In simple words: This lab test uses a special stain (in situ hybridization or ISH) to find and count specific pieces of DNA or RNA in a tissue sample, like a tumor.A lab technician prepares the sample, and a pathologist examines it under a microscope and counts the stained areas to help diagnose cancer or other conditions. This code covers the first stain; additional stains are billed separately.
CPT code 88368 encompasses the initial single probe stain procedure in morphometric analysis via in situ hybridization (ISH).This manual method involves quantitative or semi-quantitative assessment per specimen.The procedure includes the technical component (preparation of slides by lab analyst) and the professional component (interpretation and reporting by pathologist).Additional single probe stains from the same specimen are coded separately using +88369. Multiplex stains require code 88377.Modifier -TC designates the technical component only, while modifier -26 indicates the professional component only.This code is used for specimens such as formalin-fixed paraffin-embedded tumor tissue, and the results are reported either as a quantitative value (probe count) or semi-quantitative value (numerical score).
Example 1: A breast biopsy is sent to the lab for morphometric ISH analysis to quantify HER2 gene expression to determine the appropriate targeted therapy., A pathologist performs a single probe ISH stain on a cervical cancer biopsy to assess for human papillomavirus (HPV) viral load., A lung biopsy is sent to pathology for morphometric analysis to evaluate for specific gene mutations indicating non-small cell lung cancer.
* Patient demographics and relevant medical history.* Detailed description of the specimen (tissue type, source, quantity).* Information on the probe used (target sequence, type of probe).* The method of staining (manual, automated).* Quantitative or semi-quantitative results (probe count, numerical score).* Pathologist’s interpretation and diagnosis.* Supporting clinical documentation explaining the medical necessity.
** This code is specific to manual morphometric analysis of ISH using a single probe.Use appropriate codes for automated methods and multiplex stains.
- Revenue Code: T1G (LAB TESTS - OTHER)
- RVU: RVUs vary based on geographic location, facility type, and payer. Consult your local fee schedule for current values.The code includes both professional and technical components, which can be billed separately using modifiers.
- Global Days: Not applicable. This is a laboratory test, not a surgical procedure with a global period.
- Payment Status: Active
- Modifier TC rule: Modifier -TC is used to report only the technical component of the service (performed by the lab personnel). The professional component (interpretation by the pathologist) is reported separately or as part of the global service using code 88368 without a modifier.
- Fee Schedule: Fee schedules vary by payer and location. Consult your local fee schedule for historical and current payment rates.
- Specialties:Pathology, Oncology, Hematology, Genetics
- Place of Service:Hospital, Laboratory, Outpatient Clinic