CPT® Code 88155

Add-On Code

Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to code[s] for other technical and interpretation services)

CPT® Code 88155 refers to a specific cytopathology procedure that involves the evaluation of cervical or vaginal cell samples for hormonal assessment. This procedure is performed by obtaining a sample of cells from the cervix or vagina using a specialized tool, such as a stick or brush. The collected cell sample is then smeared onto a glass slide and covered with a coverslip to prepare it for microscopic examination. The definitive hormonal evaluation focuses on identifying hormonal imbalances that may affect reproductive health, including conditions that could lead to infertility. The analysis is particularly concerned with the maturation of squamous epithelial cells, which is influenced by steroid hormones, primarily estrogen. Estrogen receptors are found in the squamous epithelium of cervical and vaginal cells, with a notable presence in the basal cells. These receptors exhibit increased expression during the proliferative phase of the menstrual cycle, leading to observable changes in epithelial maturation. When the cells are examined microscopically, a quantitative analysis can be performed to assess the degree of maturation. This is represented by the maturation index (MI), which quantifies the ratio of parabasal cells, intermediate cells, and superficial cells. Normal MI values for menstruating women during ovulation are typically 0:35:65, while postmenopausal women generally show values of 90:10:0. Additionally, the karyopyknotic index (KI) is calculated to evaluate the relationship between superficial squamous cells with pyknotic nuclei and all mature squamous cells, serving as an indicator of ovulation, as the KI peaks during this phase. The estrogenic index is another component of this evaluation, which assesses the impact of estrogen therapy in postmenopausal women. Overall, CPT® Code 88155 encompasses a comprehensive approach to understanding hormonal influences on cervical and vaginal health through cytological analysis.