RE: Billing Special Stains under CPT Codes 88312 & 88313

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From:"Jennings-Siena, Debbie" <> (by way of histonet)
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The CPT code book needs to be interpreted literally.  The 88312 code is only
for stains which are used to diagnose microorganisms and the 88313 code is
for everything else.  You have to remember that the people who interpret
these codes to determine if fraud and abuse has occurred are not necessarily
medical personnel.  There is no other logic that can be applied to the
codes.  Logic and CPT codes does not exist.  If I can be of any assistance,
please do not hesitate to let me know.
Debbie J. Siena
NSH Legislative Chairperson

-----Original Message-----
From: []
Sent: Tuesday, December 14, 1999 12:23 PM
To: 'HistoNet Server' (E-mail)
Subject: Billing Special Stains under CPT Codes 88312 & 88313

Hi Everyone,
Hope your holidays have been great!

I have a question about which special stains can be billed out on CPT codes
88312 and 88313.  The CPT code book gives a couple of examples of stains for
each CPT code, with the examples for 88312 being stains for organisms.  I
have talked with a couple of labs, each of which interprets things
differently.  One bills out all organism stains under 88312 and all the
other stains under 88313. The other lab (as I do) bills out simple stains
under 88312 including PAS, Iron and mucicarminei, and uses 88313 for all
complex or expensive stains including Trichrome, Dieterle, Steiner, GMS,
etc.  I can find no list of special stains in the spt code book and which
code to use for each.  In these times of Medicare fraud being prosecuted so
much and fines so high, everyone is paranoid about these types of billing
issues for Medicare billing in particular.

Any help anyone can provide would be appreciated.  I will be glad to share
the answers with all histonet subscribers.

Thanks so much.


Michael L Johnson, BS, HTL(ASCP)
Histology Supervisor
Department of Pathology
Sacred Heart Medical Center
W. 101 8th Avenue
Spokane, WA 99220

(509) 474-4418

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