Laboratory Professionals Member Community

Hello all, I work on the industry side of things, specifically in the ROSE sector. I recently heard that pulmonologists are trying to bill 88172 when using certain new biotech devices that don't necessarily render slides. Is this possible? Would it actually be reimbursed, since there is no pathologist involved? I am looking for someone who is an expert in medical reimbursements. 

Hello all, I work on the industry side of things, specifically in the ROSE sector. I recently heard that pulmonologists are trying to bill 88172 when using certain new biotech devices that don't necessarily render slides. Is this possible? Would it actually be reimbursed, since there is no pathologist involved? I am looking for someone who is an expert in medical reimbursements. 

Hello all, I work on the industry side of things, specifically in the ROSE sector. I recently heard that pulmonologists are trying to bill 88172 when using certain new biotech devices that don't necessarily render slides. Is this possible? Would it actually be reimbursed, since there is no pathologist involved? I am looking for someone who is an expert in medical reimbursements. 

Hello all, I work on the industry side of things, specifically in the ROSE sector. I recently heard that pulmonologists are trying to bill 88172 when using certain new biotech devices that don't necessarily render slides. Is this possible? Would it actually be reimbursed, since there is no pathologist involved? I am looking for someone who is an expert in medical reimbursements. 

Yes, CPT code 88172 is

reimbursable, but reimbursement depends heavily on the specific clinical context and the individual payer's policies. 

Key Considerations for Reimbursement

• Service Performed: CPT code
  88172 describes the immediate cytohistologic study and interpretation of a fine needle aspirate (FNA) specimen to determine specimen adequacy while the patient is still present.
• Components: Reimbursement can be split into professional (physician's interpretation, modifier 26) and technical components, which are billed separately depending on who provides the service and equipment.
• Limitations: The code 88172 should not be reported for an interpretation by a medical laboratory scientist alone; it is for the physician's  or cytotechnologist's assessment of the specimen's adequacy.

Hello all, I work on the industry side of things, specifically in the ROSE sector. I recently heard that pulmonologists are trying to bill 88172 when using certain new biotech devices that don't necessarily render slides. Is this possible? Would it actually be reimbursed, since there is no pathologist involved? I am looking for someone who is an expert in medical reimbursements. 

Hello all, I work on the industry side of things, specifically in the ROSE sector. I recently heard that pulmonologists are trying to bill 88172 when using certain new biotech devices that don't necessarily render slides. Is this possible? Would it actually be reimbursed, since there is no pathologist involved? I am looking for someone who is an expert in medical reimbursements. 

Hello all, I work on the industry side of things, specifically in the ROSE sector. I recently heard that pulmonologists are trying to bill 88172 when using certain new biotech devices that don't necessarily render slides. Is this possible? Would it actually be reimbursed, since there is no pathologist involved? I am looking for someone who is an expert in medical reimbursements. 

Just sharing: 

The Medical Group Management Association (MGMA) is providing a member-exclusive webinar – scheduled for December 17, 2025, at 1 pm ET (12 pm CT, 11 am MT, 10 am PT) reviewing the yearly updates to the AMA's CPT code set.  In this presentation, attendees will review CPT® code changes effective Jan. 1, 2026. The presentation will detail new codes, deletions and revisions to existing codes. 

This 60-minute webinar will provide you with the knowledge to:

• Explain the impact of the new and revised CPT codes
• Describe changes to the calendar year 2026 CPT code set
• Determine potential areas of documentation improvement for new and revised codes

Hello all, I work on the industry side of things, specifically in the ROSE sector. I recently heard that pulmonologists are trying to bill 88172 when using certain new biotech devices that don't necessarily render slides. Is this possible? Would it actually be reimbursed, since there is no pathologist involved? I am looking for someone who is an expert in medical reimbursements. 

Just sharing: 

The Medical Group Management Association (MGMA) is providing a member-exclusive webinar – scheduled for December 17, 2025, at 1 pm ET (12 pm CT, 11 am MT, 10 am PT) reviewing the yearly updates to the AMA's CPT code set.  In this presentation, attendees will review CPT® code changes effective Jan. 1, 2026. The presentation will detail new codes, deletions and revisions to existing codes. 

This 60-minute webinar will provide you with the knowledge to:

• Explain the impact of the new and revised CPT codes
• Describe changes to the calendar year 2026 CPT code set
• Determine potential areas of documentation improvement for new and revised codes

Hello all, I work on the industry side of things, specifically in the ROSE sector. I recently heard that pulmonologists are trying to bill 88172 when using certain new biotech devices that don't necessarily render slides. Is this possible? Would it actually be reimbursed, since there is no pathologist involved? I am looking for someone who is an expert in medical reimbursements.