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Pathology/Lab Coding Alert

Reader Question:

88304 or 88305 for Ligament?

Published on Mon Nov 08, 2010

Question: My pathologist states that the work for a ligament specimen exam is equivalent to a soft tissue specimen. Is it acceptable to code the ligament specimen as 88305 instead of 88304?Answer: The answer is a conditional yes. Because "ligament" is an unlisted specimen, you should code the service based on the physician work involved compared to similar specimens, according to CPT instruction. If your pathologist says the work is similar to a soft tissue specimen, the appropriate code would be 88305 (Level IV -- Surgical pathology, gross and microscopic examination, soft tissue, other than tumor/mass/lipoma/debridement).That said, you should be cautious about reporting 88305 for a ligament specimen. Your question indicates that you're aware of the general standard that a ligament is equivalent, for average physician work, to listed specimens under 88304, specifically, tendon. A more conventional coding for a ligament specimen would be 88304 (Level III -- Surgical pathology, gross and [...]
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