Cell marker study
CPT code 88182 covers specialized laboratory tests that identify specific markers on cells to help diagnose diseases like cancer, immune disorders, or blood conditions. These tests use antibodies or other techniques to detect proteins or molecules on cell surfaces.
This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
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Billing tips
Bill each cell marker study (88182) separately when multiple markers are analyzed on the same specimen
Impact: Can increase revenue by $155.59 per additional marker; verify payer policy on maximum units per date of service
Ensure documentation specifies each antibody or marker used, the reason for testing, and the interpretation of results
Impact: Reduces denial risk by 40-60%; required for medical necessity justification and audit defense
Verify LCD and NCD policies for your MAC regarding cell marker study coverage and frequency limitations
Impact: Prevents denials for non-covered indications; some MACs limit to 8-12 markers per case without additional documentation
Use appropriate ICD-10 codes that support medical necessity, such as D47.Z9, C85.90, or D72.89 for suspected hematologic disorders
Impact: Improves first-pass payment rate by 25-35%; vague diagnosis codes trigger automatic denials
Do not bill 88182 with global codes like 88342-88346 if the cell marker study is included in the surgical pathology examination
Impact: Prevents denials for unbundling; potential recoupment of $155.59 per incorrectly billed unit
Track units billed per case and compare to pathology report to ensure accurate quantity billing
Impact: Prevents underbilling by average of 1.2-1.8 units per case; ensures capture of all billable markers performed
Common denials
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