2025 CPT code 88364
(Active) Effective Date: N/A Revision Date: N/A Pathology and Laboratory Procedures - In Situ Hybridization Surgical Pathology Procedures Feed
In situ hybridization (e.g., FISH), per specimen; each additional single probe stain.This is an add-on code used in conjunction with 88365.
Modifiers TC (technical component) and 26 (professional component) may be appended as appropriate.
Medical necessity for additional ISH staining (88364) is established when the results of the initial ISH test (88365) are insufficient to provide a conclusive diagnosis or to guide treatment decisions.This should be clearly documented in the patient's chart.
The clinical responsibility includes the lab technician performing the additional ISH stain and the pathologist interpreting the results and generating a report.The pathologist's interpretation is essential for the clinical diagnosis.
In simple words: This code covers the cost of extra tests done on a tissue sample after an initial test.A lab technician adds a special dye to look for specific genetic material, and a doctor reviews the results to help diagnose a disease, often cancer.
This CPT code, 88364, represents each additional single probe in situ hybridization (ISH) stain performed on a specimen after the initial stain (coded as 88365).The procedure involves applying an additional ISH probe to slides prepared from the same patient specimen, followed by qualitative interpretation by a pathologist to contribute to a pathologic diagnosis.This code is specifically for qualitative ISH stains; quantitative or semiquantitative ISH uses different codes (88367-88377). The code is reported per specimen, regardless of the number of slides or blocks prepared.It's crucial to note that this is an add-on code and requires the primary code 88365 for proper reimbursement.Modifiers TC (technical component) or 26 (professional component) can be appended depending on the billed services.
Example 1: A patient undergoes a biopsy for suspected breast cancer. The initial ISH test (88365) identifies a specific gene.An additional ISH probe (88364) is used to investigate other genetic markers to refine diagnosis and treatment strategy., A patient with cervical cancer undergoes an initial ISH test (88365). An additional ISH probe (88364) is used to assess the expression of a specific oncogene.This additional information helps determine the aggressiveness of the cancer and potential treatment approaches., During a colonoscopy, several polyps are identified. Biopsies are taken from multiple locations and an initial ISH test (88365) is performed.Additional ISH probes (88364) are then utilized on different biopsies to better characterize the polyps. This information is used to guide management decisions in preventing future colorectal cancer.
* Patient demographics and relevant medical history.* Detailed description of the specimen (e.g., tissue type, location).* Pathologist's report, including the results of both the initial (88365) and additional (88364) ISH stains.* Slides showing the staining results (if applicable).* Any supporting documentation relating to medical necessity.
** Code 88364 should only be used for additional single probe stains; multiplex stains use a different code (88366).If digitization of glass microscope slides is performed in conjunction with this code, code 0849T may also be reported.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: Information not available in provided text.RVUs will vary based on geographic location and other factors.
- Global Days: Not applicable. This is a pathology add-on code.
- Payment Status: Active
- Modifier TC rule: Modifier TC can be appended to bill for the technical component only (laboratory work).Modifier 26 should be used to bill for the professional component only (pathologist interpretation).If both are billed, neither modifier is used.
- Fee Schedule: Information not available in provided text.
- Specialties:Pathology, Oncology, Hematology
- Place of Service:Hospital, Laboratory, Office