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36.4.9.6 Cytopathology Studies-Other Than Gynecological
Procurement and handling of the specimen for cytopathology of sites other than vaginal, cervical, or uterine is considered part of the client's E/M and will not be reimbursed separately.
Procedure codes 5/I/T-88160, 5/I/T-88161, and 5/I/T-88162 are reimbursed only to pathologists and CLIA-certified laboratories (whose directors providing technical supervision of cytopathology services are pathologists). These procedure codes are reimbursed according to the POS where the cytopathology smear is interpreted.
The following procedures are payable in the office (POS 1), outpatient setting (POS 5), or independent laboratory (POS 6): 5-88160, 5-88161, and 5-88162.
The following procedures are payable to a pathologist in the outpatient (POS 5) and inpatient (POS 3) hospital: I-88160, I-88161, and I-88162.
• Procedure codes 5/I-88160 and/or 5/I-88161 are denied as part of 5/I-88162.
•Procedure code 5/I-88160 is denied as part of procedure code 5/I-88161.
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