CPT® Code 88121

CPT Assistant Articles
Additional Code Info
Anatomy/Physiology Online
Dictionary Definitions Illustrations
My Notes
Alerts

Newsletters
Coding Tips
Fees - Facility
Fees - Non-Facility
RVUs - Facility: Show Details
RVUs - Non-Facility: Show Details

Cross-A-Code
NCCI Edits - Facility
NCCI Edits - Non-Facility
Medicare Policies & Guidelines
PQRS

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Code History

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Anatomy & Physiology Online for Coders

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Click on a link to view the following terms in Anatomy & Physiology Online for Coders.

Anatomy of Skeletal Muscle fibers

Nuclei

Clinical

Bladder cancer (Clinical slide)
Bladder cancer (Clinical text)
Cancer (Clinical slide)
Cancer (Clinical text)

Development and Inheritance

Chromosomes

Epithelium

Urinary bladder (3D view)

Nucleic Acids

DNA
DNA: gross structure
DNA: nitrogenous bases
DNA: nucleotides
DNA: polynucleotides

Stomach

G cells

Urine Transport, Storage, and Micturition

Bladder: female
Bladder: male
Urinary bladder

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My Notes

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CPT^® Assistant Articles

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The following CPT^® Assistant Articles refer to this code (88121):

2010

Pathology and Laboratory Changes in CPT 2011 (December 2010)

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DecisionHealth^® Articles

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The following DecisionHealth^® Articles are linked to this code (88121):

Coder Pink Sheets

2011 CPT changes play big role in CCI Version 17.0 (2011)

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AHA Coding Clinic^® Articles

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Coding Tips

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Fees

Calculated for UT (84043)

* Note: Medicare may or may NOT reimburse you for this code. The fees provided below are based on values established by CMS/Medicare. Please check with your local Medicare contact on whether this code is eligible for reimbursement.

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Facility (Hospital, etc.)

Medicare vs. My Fee Evaluation

Modifier	Medicare Allowed	150%	200%	My Fee
(none)	$514.22	$771.33	$1,028.44	(your fee)
26	$48.24	$72.36	$96.47	(your fee)
TC	$465.98	$698.97	$931.96	(your fee)

Note: Subscribers with the Hospital/Facility product will see calculated values below.

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Medicare Participating - Assignment Accepted (Mandatory)

Modifier	Allowed	Medicare 80%	Patient Pays
(none)	$514.22	$##.##	$##.##
26	$48.24	$##.##	$##.##
TC	$465.98	$##.##	$##.##

Medicare Non-Participating - Assignment Accepted (Check To Doctor)

Modifier	Allowed	Medicare 80%	Patient Pays	Limiting Charge (Amount Billed)
(none)	$##.##	$##.##	$##.##	$##.##
26	$##.##	$##.##	$##.##	$##.##
TC	$##.##	$##.##	$##.##	$##.##

Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)

Modifier	Allowed	Medicare 80%	Patient Pays	Limiting Charge (Amount Billed)
(none)	$##.##	$##.##	$##.##	$##.##
26	$##.##	$##.##	$##.##	$##.##
TC	$##.##	$##.##	$##.##	$##.##

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Non-Facility (Office, etc.)

Medicare vs. My Fee Evaluation

Modifier	Medicare Allowed	150%	200%	My Fee
(none)	$514.22	$771.33	$1,028.44	(your fee)
26	$48.24	$72.36	$96.47	(your fee)
TC	$465.98	$698.97	$931.96	(your fee)

Note: Subscribers will see the calculated values below.

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Medicare Participating - Assignment Accepted (Mandatory)

Modifier	Allowed	Medicare 80%	Patient Pays
(none)	$514.22	$##.##	$##.##
26	$48.24	$##.##	$##.##
TC	$465.98	$##.##	$##.##

Medicare Non-Participating - Assignment Accepted (Check To Doctor)

Modifier	Allowed	Medicare 80%	Patient Pays	Limiting Charge (Amount Billed)
(none)	$##.##	$##.##	$##.##	$##.##
26	$##.##	$##.##	$##.##	$##.##
TC	$##.##	$##.##	$##.##	$##.##

Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)

Modifier	Allowed	Medicare 80%	Patient Pays	Limiting Charge (Amount Billed)
(none)	$##.##	$##.##	$##.##	$##.##
26	$##.##	$##.##	$##.##	$##.##
TC	$##.##	$##.##	$##.##	$##.##

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APC Fee Information

Note: APC information, including Status Indicator, Relative Weight, Payment Rate, Crosswalks, and more, is available to Subscribers with the Hospital/Facility product.

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RVUs - Relative Value Units

Calculated for UT (84043)

* Note: Medicare may or may NOT reimburse you for this code. The fees provided below are based on values established by CMS/Medicare. Please check with your local Medicare contact on whether this code is eligible for reimbursement.

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Facility 15.11 (Hospital, etc.)

RVU Components (by modifier)

Modifier	Work	Practice Expense	Malpractice Expense	Total
(none)	1	14.07	0.04	15.11
26	1	0.38	0.03	1.42
TC	0	13.69	0.01	13.7

Practitioner Work Component: 1

Pre-Service	Intra-Service	Post-Service	Total Time*
##	##	##	## min

Modifier	National Unadjusted Work RVU	Work GPCI	Adjusted Work RVU
(none)	##.##	##.##	1
26	##.##	##.##	1
TC	##.##	##.##	0

Practice Expense: 14.07

Clinical Labor - Direct Expense

Staff	Staff Rate	Pre Time	Intra Time	Post Time	Total Time*
Medical/Technical Assistant	.26 / min	## min	## min	## min	## min
Lab Technician	.33 / min	## min	## min	## min	## min
Cytotechnologist	.45 / min	## min	## min	## min	## min

* Total Time may be greater than the displayed components.

Equipment - Direct Expense

Item	Purchase Price	Expected Life	Total Time
centrifuge (with rotor)	$##.##	## years	## min
cytology thinlayer processor (ThinPrep)	$##.##	## years	## min
hood, ventilator with blower	$##.##	## years	## min
pH conductivity meter	$##.##	## years	## min
vacuum pump	$##.##	## years	## min
microfuge, benchtop	$##.##	## years	## min
water bath, FISH procedures (lab)	$##.##	## years	## min
ThermoBrite	$##.##	## years	## min
Camera (Olympus DP21)	$##.##	## years	## min
IkoniLan Software	$##.##	## years	## min
IkoniScope	$##.##	## years	## min

Supplies - Direct Expense

Item	Unit Price	Quantity	Unit	Amount
ThinPrep UroCyte Urine Collection Kit	$##.##	##	kit	$##.##
UroVysion test kit	$##.##	##	item	$##.##
gloves, non-sterile, nitrile	$##.##	##	pair	$##.##
gown, staff, impervious	$##.##	##	item	$##.##
mask, surgical	$##.##	##	item	$##.##
syringe 5-6ml	$##.##	##	item	$##.##
rubber cement	$##.##	##	ml	$##.##
centrifuge tube	$##.##	##	item	$##.##
cover slip, glass	$##.##	##	item	$##.##
cytology, lysing soln (CytoLyt)	$##.##	##	ml	$##.##
cytology, preservative and vial (Preserv-cyt)	$##.##	##	item	$##.##
fixative processing (buffered formalin)	$##.##	##	ml	$##.##
formalin	$##.##	##	ml	$##.##
immersion oil	$##.##	##	ml	$##.##
1.0N NaOH	$##.##	##	ml	$##.##
pipette tips, sterile	$##.##	##	item	$##.##
ethanol, 100%	$##.##	##	ml	$##.##
ethanol, 70%	$##.##	##	ml	$##.##
ethanol, 85%	$##.##	##	ml	$##.##
water, de-ionized	$##.##	##	ml	$##.##
ethanol, 95%	$##.##	##	ml	$##.##
Non-Gyn Filter unit	$##.##	##	item	$##.##
0.45 ?m pore filtration unit	$##.##	##	item	$##.##
12-well slides	$##.##	##	item	$##.##
ThinPrep UroCyte filter	$##.##	##	item	$##.##
Humidity cards	$##.##	##	item	$##.##
Control slides	$##.##	##	kit	$##.##
Bleach cleaning wipe	$##.##	##	item	$##.##
Fresh Fixative (3:1, methanol: acetic acid)	$##.##	##	item	$##.##
FISH pre-treatment kit	$##.##	##	kit	$##.##
biohazard specimen transport bag	$##.##	##	item	$##.##
eye shield, splash protection	$##.##	##	item	$##.##

Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.

PE RVU Components (by modifier)

Modifier	National Unadjusted PE RVU	PE GPCI	Adjusted PE RVU
(none)	##.##	##.##	14.07
26	##.##	##.##	0.38
TC	##.##	##.##	13.69

Malpractice Component: 0.04

Modifier	National Unadjusted MP RVU	MP GPCI	Adjusted MP RVU
(none)	##.##	##.##	0.04
26	##.##	##.##	0.03
TC	##.##	##.##	0.01

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Non-Facility 15.11 (Office, etc.)

RVU Components (by modifier)

Modifier	Work	Practice Expense	Malpractice Expense	Total
(none)	1	14.07	0.04	15.11
26	1	0.38	0.03	1.42
TC	0	13.69	0.01	13.7

Practitioner Work Component: 1

Pre-Service	Intra-Service	Post-Service	Total Time*
##	##	##	## min

Modifier	National Unadjusted Work RVU	Work GPCI	Adjusted Work RVU
(none)	##.##	##.##	1
26	##.##	##.##	1
TC	##.##	##.##	0

Practice Expense: 14.07

Clinical Labor (Non-Facility)- Direct Expense

Staff	Staff Rate	Pre Time	Intra Time	Post Time	Total Time*
Medical/Technical Assistant	.26 / min	## min	## min	## min	## min
Lab Technician	.33 / min	## min	## min	## min	## min
Cytotechnologist	.45 / min	## min	## min	## min	## min

* Total Time may be greater than the displayed components.

Equipment (Non-Facility)- Direct Expense

Item	Purchase Price	Expected Life	Total Time
centrifuge (with rotor)	$##.##	## years	## min
cytology thinlayer processor (ThinPrep)	$##.##	## years	## min
hood, ventilator with blower	$##.##	## years	## min
pH conductivity meter	$##.##	## years	## min
vacuum pump	$##.##	## years	## min
microfuge, benchtop	$##.##	## years	## min
water bath, FISH procedures (lab)	$##.##	## years	## min
ThermoBrite	$##.##	## years	## min
Camera (Olympus DP21)	$##.##	## years	## min
IkoniLan Software	$##.##	## years	## min
IkoniScope	$##.##	## years	## min

Supplies (Non-Facility)- Direct Expense

Item	Unit Price	Quantity	Unit	Amount
ThinPrep UroCyte Urine Collection Kit	$##.##	##	kit	$##.##
UroVysion test kit	$##.##	##	item	$##.##
gloves, non-sterile, nitrile	$##.##	##	pair	$##.##
gown, staff, impervious	$##.##	##	item	$##.##
mask, surgical	$##.##	##	item	$##.##
syringe 5-6ml	$##.##	##	item	$##.##
rubber cement	$##.##	##	ml	$##.##
centrifuge tube	$##.##	##	item	$##.##
cover slip, glass	$##.##	##	item	$##.##
cytology, lysing soln (CytoLyt)	$##.##	##	ml	$##.##
cytology, preservative and vial (Preserv-cyt)	$##.##	##	item	$##.##
fixative processing (buffered formalin)	$##.##	##	ml	$##.##
formalin	$##.##	##	ml	$##.##
immersion oil	$##.##	##	ml	$##.##
1.0N NaOH	$##.##	##	ml	$##.##
pipette tips, sterile	$##.##	##	item	$##.##
ethanol, 100%	$##.##	##	ml	$##.##
ethanol, 70%	$##.##	##	ml	$##.##
ethanol, 85%	$##.##	##	ml	$##.##
water, de-ionized	$##.##	##	ml	$##.##
ethanol, 95%	$##.##	##	ml	$##.##
Non-Gyn Filter unit	$##.##	##	item	$##.##
0.45 ?m pore filtration unit	$##.##	##	item	$##.##
12-well slides	$##.##	##	item	$##.##
ThinPrep UroCyte filter	$##.##	##	item	$##.##
Humidity cards	$##.##	##	item	$##.##
Control slides	$##.##	##	kit	$##.##
Bleach cleaning wipe	$##.##	##	item	$##.##
Fresh Fixative (3:1, methanol: acetic acid)	$##.##	##	item	$##.##
FISH pre-treatment kit	$##.##	##	kit	$##.##
biohazard specimen transport bag	$##.##	##	item	$##.##
eye shield, splash protection	$##.##	##	item	$##.##

Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.

PE RVU Components (by modifier)

Modifier	National Unadjusted PE RVU	PE GPCI	Adjusted PE RVU
(none)	##.##	##.##	14.07
26	##.##	##.##	0.38
TC	##.##	##.##	13.69

Malpractice Component: 0.04

Modifier	National Unadjusted MP RVU	MP GPCI	Adjusted MP RVU
(none)	##.##	##.##	0.04
26	##.##	##.##	0.03
TC	##.##	##.##	0.01

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Cross-A-Code™ (ICD-9, CPT, HCPCS, Modifiers, ASA CROSSWALK^®)

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Medicare Policies & Guidelines

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Physician Quality Reporting System (PQRS)

PQRS is a program where an incentive payment is made to professionals who report data on various measures.
Learn more about PQRS or Read about PQRS at cms.gov.

This code (88121) is not used with any individual PQRS measures.

Anatomy of Skeletal Muscle fibers

Clinical

Development and Inheritance

Epithelium

Nucleic Acids

Stomach

Urine Transport, Storage, and Micturition

2010

Coder Pink Sheets

AHA Coding Clinic® for HCPCS

AHA Coding Clinic^® for HCPCS