The American Medical Association CPT Editorial Panel recently announced 30 new digital pathology add-on codes that will go into effect Jan. 1, 2024.
According to the College of American Pathologists (CAP), the new digital pathology Category III CPT codes will be used to report additional service requirements associated with digitizing glass microscope slides for primary diagnosis. Additional information and descriptions for each code will be released on July 1, 2023.
Digital pathology is a dynamic, image-based environment that enables the acquisition, management, and interpretation of pathology information generated from digitized glass microscope slides. Glass microscope slides are scanned by clinical staff, and captured images (either real-time or stored in a computer server or cloud-based digital image archival and communication system) are used for digital examination for pathologic diagnosis. Digitization of glass microscope slides enable remote examination by the pathologist and/or in conjunction with used of artificial intelligence (AI) algorithms.
The current reimbursement landscape
Currently, pathologists and labs are utilizing the existing digital pathology code set to allow payers to collect data and establish consistent pricing for the add-on service in the near future. The existing category III codes, as well as these newly announced codes, have not yet received national pricing from Medicare. However, some Lighthouse clients have received payments for these codes when charging various private payers.
“It’s currently slow going for the labs waiting on reimbursement for digital pathology,” says Ann Lambrix, VP of RCM Solutions for Lighthouse Lab Services. “The fact that there isn’t established reimbursement yet can make the move to digital pathology a costly endeavor. However, the good news is we are seeing movement in recent months, as evidenced by the development of additional add-on codes.”
The new codes and their accompanying descriptors are listed below:
Digital Pathology CPT Codes: 2024
| CPT Code |
Used with: |
Long Descriptor | Effective Date |
| +0827T | 88104 | Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0828T | 88106 | simple filter method with interpretation (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0829T | 88108 | Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, Saccomanno technique) (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0830T | 88112 | Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (List separately in addition to code for primary procedure) |
1/1/2024 |
| +0831T | 88141 | Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0832T | 88160 | Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0833T | 88161 | preparation, screening and interpretation (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0834T | 88162 | extended study involving over 5 slides and/or multiple stains (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0835T | 88172 | Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (List separately in addition to code for primary procedure) |
1/1/2024 |
| +0836T | 88177 | immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in addition to code for primary procedure) |
1/1/2024 |
| +0837T | 88173 | interpretation and report (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0838T | 88321 | Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0839T | 88323 | Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0840T | 88325 | Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (List separately in addition to code for primary procedure) |
1/1/2024 |
| +0841T | 88331 | Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0842T | 88332 | each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0843T | 88333 | cytologic examination (eg, touch preparation, squash preparation), initial site (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0844T | 88334 | cytologic examination (eg, touch preparation, squash preparation), each additional site (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0845T | 88346 | Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (List separately in addition to code for primary procedure) |
1/1/2024 |
| +0846T | 88350 | each additional single antibody stain procedure (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0847T | 88363 | Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0848T | 88365 | Digitization of glass microscope slides for in situ hybridization (eg, FISH), per specimen; initial single probe stain procedure (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0849T | 88364 | each additional single probe stain procedure (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0850T | 88366 | each multiplex probe stain procedure (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0851T | 88368 | Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0852T | 88369 | each additional single probe stain procedure (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0853T | 88377 | each multiplex probe stain procedure (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0854T | 85060 | Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (List separately in addition to code for primary procedure) | 1/1/2024 |
| +0855T | 85097 | Digitization of glass microscope slides for bone marrow, smear interpretation (List separately in addition to code for primary procedure) |
1/1/2024 |
| +0856T | 88348 | Digitization of glass microscope slides for electron microscopy, diagnostic (List separately in addition to code for primary procedure) |
1/1/2024 |
If you’re seeking assistance exploring digital pathology, or are simply looking to improve your overall revenue cycle management, don’t hesitate to contact us for a free consultation.
In the 2nd paragraph you indicate the additional descriptions will come out july 1, 23 and in the bold print you indicate to check back in July of 24. I have a document with detailed description but this response does not allow attachments. If you want it, send me an email.
Hi Dana, thanks for catching that error. The second reference should have also read “July 1, 2023”, and the article has now been corrected. We were following up on CAP’s report about additional information for the new codes being released at that time, but if you have detailed descriptions you are willing to share we would gladly take them! You can email us at info@lighthouselabservices.com. Thanks!
I’m excited to see the new digital pathology codes introduced for 2024! This will help to improve the accuracy and quality of pathology reports.
Has there been any movement on reimbursement since this publication?
Hi Patsy, I believe these codes are still currently unpriced on the Medicare Fee Schedule. We’re hosting a webinar next week where we’ll cover the latest on reimbursement for digital pathology, so please feel free to sign up if you’re interested in learning more. You can register for free here: https://www.bigmarker.com/lighthouse-lab-services/Unlocking-Digital-Pathology-Key-Considerations-for-Successful-Compliant-Implementation