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Flow cytometry is a sophisticated laboratory technique utilized to analyze the characteristics of cells or particles in a fluid as they pass through a laser or other light source. The procedure involves the measurement of cell surface, cytoplasmic, or nuclear markers in various biological samples, including whole blood, serum, and bone marrow. During flow cytometry, an antigen/antibody reaction is employed to study specific proteins located on the cell membrane, as well as intracellular proteins, peptides, and DNA. The flow cytometer, which is a specialized instrument, is controlled by a computer program that manages the data acquisition process. As cells flow through the instrument, they are illuminated by lasers, and the emitted light is captured and analyzed. The results are displayed in the form of histograms, which visually represent the data collected. The interpretation of the flow cytometry results is performed by a physician, who is responsible for identifying the specific instrument and software utilized during the testing process. The physician compiles a selection of graphs and displays that illustrate the separation of cells based on their appearance and the light-emitting dyes used in the analysis. This detailed examination allows for the identification of cells of interest, which can then be further studied to provide insights into various medical conditions. Following the analysis, the physician provides a comprehensive written interpretation of the data, summarizing the findings and their clinical significance. It is important to note that different CPT® codes are designated for varying numbers of markers analyzed: code 88187 is applicable for the interpretation of 2-8 markers, code 88188 for 9-15 markers, and code 88189 for 16 or more markers.
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Flow cytometry, particularly the interpretation of 16 or more markers, is indicated for a variety of clinical scenarios where detailed cellular analysis is required. The following conditions and symptoms may warrant the use of this procedure:
The procedure for flow cytometry interpretation involving 16 or more markers consists of several key steps that ensure accurate analysis and results. Each step is critical to the overall process:
Post-procedure care following flow cytometry interpretation typically involves the review of the results with the patient and the development of a management plan based on the findings. The physician may discuss the implications of the results, including any necessary follow-up tests or treatments. Additionally, it is important to ensure that the documentation of the procedure and interpretation is complete and accurate for billing and compliance purposes. Patients may not require specific recovery measures, as the procedure is non-invasive and primarily involves laboratory analysis.
| Short Descr | FLOWCYTOMETRY/READ 16 & > | Medium Descr | FLOW CYTOMETRY INTERPRETATION 16/> MARKERS | Long Descr | Flow cytometry, interpretation; 16 or more markers | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 2 - Professional Component Only Code | 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 | Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x) | 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 |
| GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary | 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. | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 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 | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | 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. | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GW | Service not related to the hospice patient's terminal condition | 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 | SA | Nurse practitioner rendering service in collaboration with a physician | 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. | 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. | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | 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. | 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. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | 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 | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | KX | Requirements specified in the medical policy have been met | LT | Left side (used to identify procedures performed on the left side of the body) | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | QW | Clia waived test | RT | Right side (used to identify procedures performed on the right side of the body) |
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Notes
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| 2013-01-01 | Changed | Guideline information changed. Also revised parenthetical note per AMA 2013 corrections document dated 2013-03-25. |
| 2011-11-30 | Changed | AMA Guidelines correction of code from 026Xt1 to 0279T per Corrections Notice 2012 |
| 2011-01-01 | Changed | Short description changed. |
| 2005-01-01 | Added | First appearance in code book in 2005. |
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