Is D0480 covered by insurance?

Coverage for D0480 varies by insurance provider; it's important to verify with the patient's plan for specific guidelines.

How is the sample for D0480 collected?

The sample is collected through mild scraping of the oral mucosa to gather non-transepithelial cells for analysis.

Can D0480 be used for routine screenings?

Yes, especially for high-risk patients, but it's essential to document the clinical necessity for each case.

What should be included in the written report for D0480?

The report should include microscopic findings, clinical implications, and recommendations for further action if needed.

D0480

Cytologic Smears Accession - CDT Code Guide

Diagnostic/Oral Pathology Laboratory

Overview

CDT Code D0480 is designated for the accession of exfoliative cytologic smears, which involves the collection of non-transepithelial cell samples from the oral mucosa through mild scraping. This procedure is crucial for diagnosing various oral pathologies, as it allows for microscopic examination of cells to detect abnormalities. Typically, this code is used in scenarios where there is a suspicion of oral lesions or conditions that require further investigation beyond visual examination. The collected samples are prepared and analyzed in a laboratory setting, and a comprehensive written report is generated to guide further clinical decisions.

When to Use This Code

When a patient presents with unexplained oral lesions or sores.
In cases where there is a need to monitor previously identified oral pathologies.
For patients with a history of oral cancer, to check for recurrence.
When non-invasive diagnostic methods are preferred over biopsy.
In routine screenings for high-risk patients with a history of tobacco use or HPV.

Documentation Requirements

Detailed patient history and clinical findings leading to the procedure.
Description of the lesion or area sampled, including size and location.
Method of sample collection and handling procedures.
Laboratory report with microscopic examination findings.
Written report transmission details, including date and recipient.

Billing Considerations

Ensure accurate documentation of the clinical necessity for the procedure. Be aware of any frequency limitations imposed by insurance providers. Common modifiers may include those indicating separate and distinct procedures. Verify coverage with the patient's insurance, as some plans may have specific guidelines for pathology services.

Related CDT Codes

D0150 D0180 D0470 D0417 D0418

Frequently Asked Questions

D0480 is used for collecting and analyzing cell samples from the oral mucosa to diagnose potential pathologies.

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