2025 CPT code 88373
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Surgical Pathology Procedures Pathology and Laboratory Procedures Feed
Each additional single probe stain procedure in morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen.
Modifiers 26 (professional component) and TC (technical component) are applicable depending on who is billing for the service.Other modifiers (e.g., 59, 79) might apply depending on the circumstances of the service.
Medical necessity for this test depends on the clinical context, usually related to diagnosing, staging, and guiding treatment for specific cancers. The decision to perform an additional stain should be based on findings from the initial ISH procedure or other clinical indicators.
The clinical responsibility is shared between the lab analyst (technical component) and the pathologist (professional component). The lab analyst prepares the slides and performs the staining and computer-assisted analysis. The pathologist reviews the slides and the computer data and provides the interpretation and diagnostic report.
In simple words: This lab test involves adding another special stain to a tissue sample to help diagnose a condition, often cancer.It uses a computer to count how much of the stain is present and a doctor examines the results to make a diagnosis. This code is only used if a similar test has already been done and is reported separately.
This CPT code, 88373, represents each additional single probe stain performed as part of a morphometric analysis using in situ hybridization (ISH), which is quantitative or semi-quantitative and utilizes computer-assisted technology.The procedure is conducted on a specimen, following an initial single probe stain (coded separately using 88367). The lab analyst applies the additional stain, processes the slides using computer-assisted technology for probe counting/estimation, and a pathologist interprets the results to aid in diagnosis. This code is an add-on code and requires the primary code 88367 to be reported.
Example 1: A patient undergoes a biopsy for suspected breast cancer.An initial ISH single probe stain (88367) is performed, revealing the need for additional analysis.A second probe is applied (88373) to quantify HER2 expression for targeted therapy decisions., A patient with a suspicious cervical lesion has an initial ISH single probe stain performed (88367). Results show borderline findings.An additional probe is run (88373) to confirm the presence or absence of high-risk HPV types., A patient with bladder cancer has a biopsy.An initial ISH study (88367) is done. Further analysis with an additional probe (88373) is needed to determine the extent of tumor involvement.
* Patient demographics and relevant medical history.* Detailed description of the procedure and the specific probes used.* Microscopic slides images, including images of the stained slides.* Computer-generated data from the morphometric analysis (probe counts or scores).* Pathologist's interpretation and diagnostic report.* Medical necessity documentation to support testing.
** Always refer to the most current CPT codebook and relevant payer guidelines for the most up-to-date information regarding coding and reimbursement.Proper documentation is crucial for accurate coding and appropriate payment.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: This information is not provided and should be referenced using the most current RVU data from CMS.
- Payment Status: Active
- Modifier TC rule: Modifier TC (technical component) may be appended if only the technical aspect of the service is being billed. Modifier 26 applies if only the professional component is billed.
- Fee Schedule: Fee schedule information varies by payer and location. Refer to current fee schedules or contract agreements for accurate payment information.
- Specialties:Pathology, Oncology, Hematology
- Place of Service:Hospital, Laboratory, Outpatient setting