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The CPT® Code 88120 refers to a specific cytopathology procedure that utilizes in situ hybridization techniques, such as fluorescence in situ hybridization (FISH), to analyze urinary tract specimens. This procedure is particularly focused on identifying abnormal cells that may indicate the presence of urinary tract cancer. The specimens typically analyzed include urine samples or bladder irrigation specimens, which contain exfoliated urothelial cells. The in situ hybridization technique involves the application of multiple DNA probes—ranging from three to five—that are designed to detect genetic alterations associated with cancerous changes in the urinary tract. Each DNA probe is labeled with a fluorescent dye, allowing for visualization under a fluorescent microscope. When the probes bind to their complementary DNA sequences within the cell nuclei, they highlight specific chromosomes that may exhibit changes indicative of malignancy. The resulting fluorescence observed under the microscope serves as a critical indicator of chromosomal abnormalities, aiding in the diagnosis of urothelial cancer. It is important to note that this code is applicable for manual testing; if computer-assisted technology is employed for the evaluation of the specimen, the appropriate code to use would be 88121. Each specimen tested, whether manually or with computer assistance, should be reported using the corresponding codes to ensure accurate documentation and billing.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure represented by CPT® Code 88120 is indicated for the evaluation of urinary tract specimens in the context of suspected malignancies. The following conditions or symptoms may warrant the use of this procedure:
The procedure for CPT® Code 88120 involves several key steps to ensure accurate analysis of the urinary tract specimen. The following outlines the procedural steps:
Post-procedure care for patients undergoing the CPT® Code 88120 test typically involves monitoring for any immediate complications related to the specimen collection, such as discomfort or bleeding. Patients may be advised to maintain hydration to facilitate urinary flow. The results of the test are usually communicated to the referring physician, who will interpret the findings in the context of the patient's clinical picture. Follow-up appointments may be scheduled to discuss the results and any further diagnostic or therapeutic steps that may be necessary based on the findings of the in situ hybridization analysis.
| Short Descr | CYTP URNE 3-5 PROBES EA SPEC | Medium Descr | CYTP INSITU HYBRID URINE SPEC 3-5 PROBES EA MNL | Long Descr | Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | T-Packaged Codes | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1G - Lab tests - other (Medicare fee schedule) | MUE | 2 | CCS Clinical Classification | 234 - Pathology |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | 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. | GZ | Item or service expected to be denied as not reasonable and necessary | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | RT | Right side (used to identify procedures performed on the right side of the body) | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | 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 | Added | Added |
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