Radiology & Pathology/Laboratory Coding

Radiology and pathology are two distinct CPT sections that CPC candidates must understand. While they differ in clinical focus, both share the concept of component billing and require attention to specific coding conventions.

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Radiology Coding (70010-79999)

Radiology Subsections

Component Billing (Professional vs. Technical)

Most radiology procedures have two billable components:

Example Scenario:

• Patient gets a chest X-ray at an independent imaging center where the radiologist is employed → Global billing (no modifier)
• Patient gets a chest X-ray at a hospital, and an outside radiologist interprets it → Hospital bills -TC, radiologist bills -26

Contrast Designations

Imaging studies are coded based on contrast usage:

Key Rule: "Without followed by with" is a SEPARATE code from "without" or "with" alone — do NOT report two separate codes for each phase.

Supervision and Interpretation (S&I)

Some surgical procedures involve radiologic guidance. In these cases:

• The surgical procedure is coded from the Surgery section
• The radiologic supervision and interpretation (S&I) is coded from the Radiology section
• Both codes may be reported if the physician performs both the procedure AND the S&I
• If different physicians perform the procedure and the S&I, each bills their respective code

Example: A physician performs a lumbar puncture with fluoroscopic guidance:

• 62270 (Lumbar puncture) + 77003 (Fluoroscopic guidance for needle placement)

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Pathology & Laboratory Coding (80047-89398)

Major Pathology Subsections

Organ/Disease Panels

Panels are predefined groups of tests that must be performed in their entirety:

Key Rule: If all component tests of a panel are performed, report the panel code. If even one test is missing, you cannot report the panel — report each individual test code instead. If additional tests beyond the panel are performed, report the panel code PLUS the individual codes for the extra tests.

Surgical Pathology Levels (88300-88309)

Surgical pathology is coded based on the level of examination required:

Key Rule: The level is determined by the specimen type, NOT by the pathologist's time or effort. CPT provides a detailed list of specimens assigned to each level. If the specimen is not listed, use the closest comparable level.

Drug Testing

Presumptive testing is typically a single code regardless of the number of drug classes tested. Definitive testing is coded per drug or drug metabolite identified.