Pathology/Lab Coding Alert

Question: The pathologist dictates, "Lymph node segregated from breast tissue for extensive macroscopic exam and dissection using sterile technique. ... The node is bisected, revealing a suspicious area. One portion is placed in cassette for routine processing. Another section is serially sectioned and labeled in preparation for BRCA-1BRCA-2 gene analysis." Can we bill 88305 and 88387?Massachusetts SubscriberAnswer: Yes, the documentation you present should warrant reporting both 88305 (Level IV - Surgical pathology, gross and microscopic examination, lymph node, biopsy) and 88387 (Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies [e.g., nucleic acid-based molecular studies]; each tissue preparation [e.g., a single lymph node]), but there are a couple of caveats.Watch edits: Medicare's Correct Coding Initiative (CCI) bundles 88387 as a column 2 code with 88305. Some experts maintain that because the pathologist in this case performs distinct services on uniquely identified and processed sites from a single lymph [...]