Billing Beat

Flow Cytometry Code Update

July 3, 2006

Effective retroactively for dates of service on or after November 1, 2005, CPT-4 code 88182 (flow cytometry, cell cycle or DNA analysis) is added as a Medi-Cal benefit. Also effective retroactively for dates of service on or after November 1, 2005, the following flow cytometry codes have been assigned specific prices. Codes 88184 and 88145 must be billed with modifier -TC (technical component). Codes 88187, 88188 and 88189 must be billed with modifier -26 (professional component).

The full descriptions and prices for the codes are:

CPT-4 Code Description Medi-Cal Rate
88182 Flow cytometry, cell cycle or DNA analysis $88.27
88184 Flow cytometry cell surface, cytoplasmic, or nuclear marker, technical component only; first marker $42.18
88185 Flow cytometry cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker $20.68
88187 Flow cytometry, interpretation; 2 to 8 markers $55.98
88188 Flow cytometry, interpretation; 9 to 15 markers $69.84
88189 Flow cytometry, interpretation; 16 or more markers $92.02

No action is required on the part of providers. Claims submitted with these codes for dates of service beyond the six-month billing limit must include delay reason code “11” in the COB (Delay Reason) field (Box 24J) and documentation justifying the delay.

Sign up for Billing Beat