Pathology/Lab Coding Alert

Question: Is it possible to charge for the lymph node portion of the dissection separately from the main specimen? For example, a colectomy or gastrectomy specimen with malignant tumor is assigned 88309. California Subscriber Answer: Generally, lymph nodes are not to be separately coded when the nodes are a part of the resected 88309 (Level VI Surgical pathology, gross and miscoscopic examination) specimen.

Some resections would not typically include lymph nodes as an integral part of the specimen, such as prostatectomy, hysterectomy, tonsillectomy, etc. If regional lymph nodes are removed in addition to these specimens, they are a separate evaluation service, 88307 (Level V ... Lymph nodes, regional resection). For example, a pathologist might remove the prostate and the right iliac lymph nodes, which would be reported as 88309 and 88307. The pathologist must determine if the lymph nodes are integral to or separate from the specimen. Reader Questions and You Be the Coder were answered and/or reviewed by William Dettwyler, MT-AMT, coding analyst for Health Systems Concepts, laboratory coding and compliance consultants in Longwood, Fla.; and R.M. Stainton Jr., MD, president of Doctors' Anatomic Pathology Services in Jonesboro, Ark.