© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 88121 refers to a specialized cytopathology procedure that utilizes in situ hybridization techniques, specifically fluorescence in situ hybridization (FISH), to analyze urinary tract specimens. This procedure is designed to detect the presence of abnormal cells that may indicate urinary tract cancer. The specimens typically analyzed include urine samples or bladder irrigation specimens, which contain exfoliated urothelial cells. The process involves the application of multiple DNA probes—ranging from three to five—that are specifically designed to target and identify chromosomal 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 genetic abnormalities. The resulting fluorescence indicates the presence of chromosomal changes that are characteristic of urothelial cancer. It is important to note that this code is applicable when computer-assisted technology is employed for the evaluation of the specimen, distinguishing it from the manual testing process, which is reported under CPT® Code 88120. Each specimen tested, whether through manual or computer-assisted methods, should be reported accordingly to ensure accurate coding and billing.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure represented by CPT® Code 88121 is indicated for the evaluation of urinary tract specimens in patients suspected of having urinary tract cancer. The following conditions may warrant the use of this test:
The procedure for CPT® Code 88121 involves several critical steps to ensure accurate analysis of the urinary tract specimen. The following outlines the procedural steps:
Post-procedure care for patients undergoing the test associated with CPT® Code 88121 typically involves monitoring for any immediate reactions to the specimen collection process. Patients may be advised to hydrate adequately following the collection of urine specimens. The results of the test will be communicated to the healthcare provider, who will discuss the findings with the patient and determine any necessary follow-up actions based on the results. It is essential for healthcare professionals to ensure that patients understand the implications of the test results and any further diagnostic or therapeutic steps that may be required.
| Short Descr | CYTP URINE 3-5 PROBES CMPTR | Medium Descr | CYTP INSITU HYBRID URNE SPEC 3-5 PROBES CPTR EA | Long Descr | Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology | 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 | STV-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 |
| 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 | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | 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. | 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. | 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. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GB | Claim being re-submitted for payment because it is no longer covered under a global payment demonstration | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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 | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2011-01-01 | Added | Added |
Get instant expert-level medical coding assistance.