CPT® Code 88358

1. Indications

The morphometric analysis procedure, represented by CPT® Code 88358, is indicated for various conditions and symptoms associated with malignant tumors. The following are the specific indications for which this procedure is performed:

• Malignant Tumors - The procedure is utilized on tissue samples previously identified as malignant through histopathology to assess tumor characteristics.
• Prediction of Tumor Aggressiveness - It aids in predicting how aggressive a tumor may be, which is essential for treatment planning.
• Prognostic Assessment - The analysis provides prognostic information that can influence patient management and therapeutic strategies.
• Assessment of DNA Ploidy - It is specifically used to determine the DNA ploidy of chromosomes in cell nuclei, which is critical for understanding tumor biology.
• Evaluation of Secondary Neoplasms - The procedure is also indicated for identifying secondary neoplasms in various organs, including the lungs, adrenal glands, and digestive organs.
• Carcinoma in Situ - It can assess carcinoma in situ in the colon, liver, bile ducts, and other related organs.
• Non-Hodgkin’s Lymphoma - The analysis is applicable in the evaluation of non-Hodgkin’s lymphoma.
• Gastrointestinal Conditions - It is indicated for conditions such as ulcers of the esophagus, regional enteritis, and ulcerative colitis.

2. Procedure

The morphometric analysis procedure involves several detailed steps to ensure accurate assessment of the tumor sample. The following outlines the procedural steps involved:

• Step 1: Tissue Sample Preparation - The first step involves obtaining a tissue sample that has been previously diagnosed as malignant through histopathology. This sample is then prepared for analysis by embedding it in either plastic or paraffin, which preserves the cellular structure for further examination.
• Step 2: Imaging - Once the tissue sample is prepared, it is subjected to imaging techniques using light or fluorescent microscopy. This imaging allows for the visualization of the cellular architecture and nuclear characteristics of the tumor.
• Step 3: Data Collection - During the imaging process, data is collected regarding the cellular and nuclear features of the tumor. This data is crucial for the subsequent analysis and interpretation of the tumor's characteristics.
• Step 4: Qualitative Morphometry - The collected data undergoes qualitative morphometric analysis, which involves measuring and analyzing the shapes, sizes, and arrangements of the cell nuclei. This step is essential for determining the nuclear ploidy and other phenotypic characteristics of the tumor.
• Step 5: Computerized Data Reduction - The final step involves the use of computerized data reduction techniques to analyze the morphometric data. This process helps in synthesizing the information and deriving meaningful conclusions regarding the tumor's DNA ploidy and potential behavior.

3. Post-Procedure

After the morphometric analysis procedure is completed, there are several considerations for post-procedure care and follow-up. The results of the analysis will be compiled and interpreted, providing critical information regarding the tumor's aggressiveness and prognosis. This information is then communicated to the healthcare provider, who will use it to guide treatment planning and management strategies for the patient. It is important for the healthcare team to discuss the findings with the patient, including any implications for further treatment or monitoring. Additionally, ongoing follow-up may be necessary to assess the patient's response to treatment and to monitor for any changes in the tumor's characteristics over time.