Standard CPT Pathology Codes & Their Roles In Medical Billing?

Touseef Riaz

February 20, 2023

CPT pathology codes

Pathology codes are used in pathology. It describes the nature of the specimen studied by a pathologist. They can be found in medical billing and insurance claims. They can also be found in other areas where clinical information is required. CPT pathology codes identify the cause of a patient’s condition. They are used in medical billing to determine the cost of services and procedures.

Standard CPT Pathology Codes and Their Roles In Medical Billing

Medical billing service has gained popularity these days among clinics and other medical facilities. It is an essential part of the healthcare industry, which helps you save time, money, and effort by providing a comprehensive solution to all your billing-related problems.

In this article, we will discuss what medical billing services are. Why are they needed in the healthcare industry? How can they help you out with your practice management processes?

What is the role of CPT Pathology Codes in Medical Billing?

CPT stands for Current Procedural Terminology. It is an internationally recognized coding system. It provides uniformity across healthcare facilities and providers. It allows you to compare costs between different healthcare providers quickly. It makes comparisons based on geographical location or other factors. These factors are type/timing of service delivery (e.g., emergency vs. non-emergency care).

What is Pathology? 

Pathology is the study of disease. It involves diagnosing infections and pathologies of human body organs. Pathologists are physicians who specialize in pathology and help diagnose diseases. They diagnose the diseases by examining tissue samples for signs of illness/injury.

Pathologists also use laboratory technologies such as microscopes, blood tests, and DNA analysis. These techniques were used to investigate these conditions further.

Different Types of Pathological Labs 

There are several types of pathology labs. These labs include histopathology, microbiology laboratory, and molecular genetics laboratory. Each type has its specific code and purpose.

Histopathology: Study of tissue samples from a patient’s Body. To look out for signs of disease/abnormality.

Microbiology laboratory: A lab where doctors can perform tests on bacteria or viruses. They determine if there is an infection present in your Body. These tests are often done to help diagnose certain diseases like tuberculosis (TB).

Molecular Genetics Laboratory: A lab where doctors can test DNA. They test it to determine if a genetic mutation exists in your Body. These tests are often done to help diagnose certain diseases. These diseases include cancer or Down syndrome. At the same time, many pathology labs are private. Some hospitals also have a lab that can perform these tests.

Histopathology Laboratory: A medical facility where doctors can take samples from your Body. They look at them under a microscope to see if there is any sign of cancer. This testing can be done on tissue samples taken during surgery or biopsies.

Cytology Laboratory: A medical facility where doctors can take samples from your Body. Then they look at them under a microscope to check for any infection indications. This testing can be done on swabs taken during an exam or biopsy.

Who are Pathologists? 

Pathologists are medical professionals with a focus on the diagnosis of diseases. The role of a pathologist is to study tissue from patients and make a diagnosis based on what they find. Pathology is a subspecialty of medicine. Pathologists may be board certified in anatomic, clinical, or forensic pathology.

What are the different types of Pathology Services? 

Pathology services are a type of healthcare. It involves the microscopic examination of cells and tissues. It helps to diagnose diseases and conditions.

Pathology services include microscopic examination of cells, tissues, organs, and body fluids. It also includes other molecular diagnostics, such as genetic testing.

What is CPT? 

The codes are 10-digit numbers used by medical professionals to describe their services. The American Medical Association (AMA) updates the CPT codes. Which also maintains a database of all the CPT codes.

The codes allow providers and patients to know about the care they’re getting so that both parties can be billed correctly. The Codes were developed so everyone would understand what was being billed for. Moreover, how much it should cost them (and insurers would know how much they were paying out).

History of CPT codes 

Medicare and Medicaid Services (CMS) began using the codes in 1969. These code sets have been revised over the years. But they are still used today to describe patients’ conditions and treatments.

CPT stands for Current Procedural Terminology. It is a standardized set of codes used by healthcare professionals. They used it to document health information about patients during clinical encounters. The first edition of CPT was published in 1983. It included only four major body systems: cardiovascular disease (CV), diabetes mellitus (DM), and respiratory system disorders (RSD). It also consists of some others, such as neoplasms.

Why are CPT Codes used in Pathology?

CPT codes are used to bill for pathology services. They provide a standard way of describing the pathology service. That helps to ensure that the correct code is used and helps to ensure that valid code is used.

How are Pathology Medical Billing Services Changing?

There are many reasons for this, but one of the biggest is that health systems are becoming more aware of the cost savings and efficiency benefits of pathology medical billing services. In addition to providing a better quality care experience for patients, pathology medical billing services can also help hospitals reduce their costs by eliminating unnecessary testing or procedures that don’t need to be done.

The decline in health system costs is something you’ll see more often as time goes on, which means it’s important for providers to make sure they’re using all available resources when it comes to paying their bills.

Pathology and Laboratory Coding Guidelines 2022 

The pathology and laboratory coding guidelines are rules for the medical laboratory. These rules have to follow when reporting medical test results. These guidelines provide an overview of what information is required in each report. It also includes information on how it should be said. They also give examples of how to format messages based on those guidelines.

Healthcare providers use the CPT codes to submit bills to insurers. They also use these codes to submit bills to government agencies. These agencies include Medicare and Medicaid. The codes are standardized across all healthcare professionals. But, they can vary from one provider to another based on specific procedures. A doctor or specialist will perform such procedures during an appointment or procedure session. It can take place at their office location.

Pathology CPT Codes 2022

The pathology code is also called the Code of Medical Practices (CMP) code 2022. It is used in medical billing to identify the service type provided. For example, it is listed after a patient’s name and medical insurance information on an invoice. It can also be listed on other documentation. Examples of CPT codes for lab tests 2022 are listed below:

88104  Cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation.

88106  Cytopathology, fluids, washings, or brushings, except cervical or vaginal; filter method only with interpretation.

88107  Cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears and filter preparation with interpretation

88108 Cytopathology, concentration technique, smears, and interpretation (e.g., Saccomanno technique) (For the performance of smear, use 88104; for cell block interpretation, use 88305.)

88125  Cytopathology, forensic (e.g., sperm) 88130 Sex chromatin identification; Barr bodies.

88140  Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks. 

88365 CPT code description 

88365 Tissue in-situ hybridization, interpretation, and report.

Categories of Surgical Pathology CPT codes

This list of CPT codes for lab tests is a combination of two categories:

1) gross and microscopic examination. It is further divided into six levels. Each level has a particular set of specimens.

2) service code (e.g., cytopathology and pathology).

CPT 88300 – Surgical Pathology level 1 Gross Examination only

Any specimen investigating pathologists think may be appropriately diagnosed “without” microscopic investigation is given the service code 88300. CPT 88330 is used to report a pathology level 1 gross examination.

The code will be added when you have completed the first phase of your work on the case or if you need a second opinion on it. This code can also be used in conjunction with other regulations, such as CPT 88302 or CPT 88309.

CPT 88302 – Surgical Pathology, Gross and Microscopic Examination of Specimen

CPT pathology codes 88302 is a level 2 code. The specimen is revived grossly and also under a microscope. It describes reviewing a slide that has already been scanned at a lower level. It provides more detail on the findings of that previous level. Different organs can be viewed at this level. For example, a Hernia sac in any location, hydrocele sac, nerve skin, plastic repair, sympathetic ganglion, etc.

CPT 88304 – Surgical Pathology level 3 Complex Microscopic and Report 

The CPT 88304 code is used for clinical pathology services. The result of this code will be sent in a report, which can be used to help diagnose and treat patients. In addition, this level is used for the diagnosis of different structures. For example, hematoma, hemorrhoids, hydatid of Morgagni, intervertebral disc, joint, loose Body, meniscus, mucocele, salivary neuroma, Morton’s/Traumatic Pilonidal Cyst/Sinus, etc.

CPT 88305 – Surgical Pathology level 4 Gross, Microscopic, and Special Stains

CPT 88315, also known as level 4 pathology. In these services, a specialist/consultant is required to review the gross and microscopic examination of the specimen. This code indicates that you need a pathologist on site. He can help interpret your tissue samples. He can also make recommendations about treatment options for your patient. The specimens for this level are cervix biopsy, colon biopsy, duodenum biopsy, endocervix curetting/biopsy, endometrium curetting/biopsy, esophagus biopsy, extremity amputation/ traumatic, etc.

CPT 88307 – Surgical Pathology level 5 Gross and Microscopic Examination  

CPT pathology codes 88307 are used for gross and microscopic examination of specimens. Some specimens of this level are myocardium biopsy, odontogenic tumor, salivary gland, sentinel lymph node, etc.

You can find the pathology CPT codes pdf from this link (

Benefits of Pathology Billing Services

They provide various services like:

  • revenue cycle management. 
  • eligibility verification. 
  • claim submission. 
  • denial management.
  • handling worker’s compensation claims.
  • creating reports to track billable hours by physician or procedure type.
  • maintaining accounts receivable status reports by an insurance company or patient).
  • generating patient statements.
  • collections report (aging report) showing the amount owed by the patient).
  • Enforcing compliance with your company’s procedures and policies.
  • Ensuring that your insurer receives all necessary documentation.
  • comply with government regulations involving health care laws such as HIPAA.

What is the Role of a Medical Billing Company in Billing?

Pathology medical billing services are an administrative support function that helps pathologists with their daily practice and patient involvement. It also handles the payment for pathology labs, hospitals, and clinics.

The main job of a pathology medical billing company is to ensure that all bills are paid on time by collecting payments from clients or Medicare/Medicaid programs. They also provide backup support when needed in case there are any issues during the collection or processing of payments.

The primary function of a medical billing service is to prepare claims and invoices (coding) for insurance companies. As a result, they can reimburse a doctor or hospital for services rendered.

The process starts with an intake, where the patient submits their information and asks the doctor’s office to submit the claim. Then, after approving all documentation related to diagnosis/treatment plans, the claim submission was sent off electronically via email. Then, the doctor finally gets reimbursement after verification of all documents. 


It is an overview of the mainly used CPT pathology codes. There are many more, which will be discussed in future sections. But this post should give you an idea of how familiar pathologists use these codes. U Control Billing provides the best solution to your needs in pathology medical billing. Our services will also assist you in every part of your medical billing.



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