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2025 CPT code 88367

Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure.

Follow current CPT coding guidelines for surgical pathology procedures. Ensure accurate representation of the performed services and appropriate use of modifiers (TC for technical component, 26 for professional component) as applicable.

Modifiers TC (Technical Component) and 26 (Professional Component) can be appended to this code depending on which component of the service is being billed. Other modifiers might be applicable depending on the specific circumstances of the service provided. Consult the most current CPT guidelines and local payer policies for the most accurate modifier application.

Medical necessity for this test is established when the results are clinically relevant for diagnosis, staging, prognosis, or treatment planning of a specific condition, such as cancer, guided by established guidelines and appropriate medical decision-making.

The clinical responsibility is shared between the lab analyst (technical component) and the pathologist (professional component). The lab analyst prepares and stains the slides using in situ hybridization, and the pathologist interprets the results and generates the diagnostic report.

IMPORTANT:Codes 88373 (each additional single probe stain) and 88374 (multiplex probe stain) are used for additional stains on the same specimen.Codes 88364-88366 are used for qualitative ISH stains without quantitative or semi-quantitative evaluation. For cytology specimens (cellular material) for bladder cancer, use codes 88120-88121 instead. For ISH tests assessing conditions other than cancer (e.g., heritable diseases), use codes 88271-88275.If a non-pathologist interprets the results, use codes 88271-88275.

In simple words: This lab test uses a special stain to look for specific genes in a tissue sample, like a tumor. A computer helps count the stained areas, and a doctor analyzes the results to help diagnose cancer or other conditions.

This CPT code encompasses the morphometric analysis of an in situ hybridization (ISH) stain, specifically for a quantitative or semi-quantitative evaluation using computer-assisted technology.It applies to the initial single probe stain on a specimen, such as tumor tissue. The procedure involves the lab analyst preparing slides, applying the ISH stain (which includes a DNA or RNA probe), utilizing computer-assisted technology for probe enumeration, and a pathologist interpreting the results to provide a pathologic diagnosis.The code represents the global service, encompassing both the technical component (lab analyst's work) and the professional component (pathologist's interpretation and reporting).

Example 1: A patient presents with a suspicious breast mass. A biopsy is performed, and the tissue sample is sent to the lab for morphometric ISH analysis using code 88367 to assess the presence of HER2 gene amplification, aiding in breast cancer diagnosis and treatment planning., A cervical biopsy is sent for ISH analysis to detect the presence of human papillomavirus (HPV) DNA.Code 88367 is used for the initial single probe stain to quantify HPV viral load, which helps in risk assessment and management., A patient with a history of bladder cancer undergoes a cystoscopy. A tissue sample is obtained for ISH testing, but due to the nature of the specimen (cellular), the appropriate code would be 88120-88121 instead of 88367. This exemplifies the importance of correct specimen identification.

* Patient demographics and relevant clinical history.* Detailed description of the specimen (tissue type, source, and identification).* Number and type of probes used in the ISH analysis.* Results of the computer-assisted morphometric analysis (quantification or semi-quantification).* Pathologist's interpretation and diagnostic report.* Confirmation that the test was ordered appropriately for the clinical indication and patient.

** This code should only be used for quantitative or semi-quantitative ISH stains using computer-assisted technology and a single probe.Accurate documentation is essential for appropriate coding and reimbursement.

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