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Cytopathology examination, specifically for cervical or vaginal specimens, is a critical diagnostic procedure aimed at identifying cellular changes that may indicate the presence of disease. This examination is particularly important for detecting conditions such as cervical dysplasia and in situ carcinoma, which are precursors to invasive malignant diseases. The procedure is commonly known as a Papanicolaou (PAP) smear, named after Dr. George Papanicolaou, who developed the technique. During the test, cells are collected from the endocervix using a specialized instrument, such as a brush or stick, and are then placed in a preservative fluid to maintain their integrity for laboratory analysis. Once the specimen reaches the laboratory, it undergoes a series of processing steps. The liquid cell suspension is centrifuged to eliminate debris and concentrate the cervical cells, facilitating easier retrieval and examination. The prepared cells are then subjected to an automated thin layer preparation system, which stains the cells and transfers them onto slides for microscopic evaluation. This automated system not only prepares the slides but also performs an initial screening of the smears. In the context of CPT® Code 88174, the automated screening process is conducted under the supervision of a physician, typically a pathologist, who reviews the results generated by the automated system. This ensures that any potential abnormalities are accurately identified and addressed. If the automated screening indicates any irregularities, further diagnostic procedures may be recommended, including additional PAP smears or more invasive tests such as colposcopy, endocervical curettage, or biopsy, to ensure comprehensive evaluation and management of the patient's health.
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The cytopathology examination using CPT® Code 88174 is indicated for the following conditions:
The procedure for CPT® Code 88174 involves several key steps to ensure accurate cytopathological evaluation:
After the cytopathology examination is completed, the results are reviewed by the supervising physician. If any abnormalities are detected during the automated screening, the pathologist may recommend further diagnostic actions. This could include scheduling another PAP smear at a shorter interval than usual or conducting additional tests such as colposcopy, endocervical curettage, or biopsy to obtain more definitive information regarding the patient's cervical health. The follow-up care and recommendations will depend on the findings of the initial examination and the clinical context of the patient.
| Short Descr | CYTOPATH C/V AUTO IN FLUID | Medium Descr | CYTP C/V AUTO THIN LYR PREPJ SCR SYS PHYS | Long Descr | Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | CLIA Waived (QW) | No | APC Status Indicator | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 234 - Pathology |
This is a primary code that can be used with these additional add-on codes.
| 88155 | Female Edit Addon Code MPFS Status: Statutory exclusion (from MPFS, may be paid under other methodologies) APC Q4 PUB 100 CPT Assistant Article 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) |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GA | Waiver of liability statement issued as required by payer policy, individual case | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2011-01-01 | Changed | Short description changed. |
| 2003-01-01 | Added | First appearance in code book in 2003. |
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