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Pathology/Lab Coding Alert

Reader Question:

KOH Test Stands Alone

Published on Tue Feb 07, 2012

Question: Our lab receives a toenail excision with some attached skin for a fungal test. We examine the specimen using a KOH preparation test. Should we report a surgical pathology tissue exam in addition to the KOH test?Ohio SubscriberAnswer: Because you don't give any indication that a pathologist performed a gross and microscopic exam apart from the potassium hydroxide (KOH) test, you should not report a surgical pathology exam for skin or an unlisted specimen (toenail), such as 88304 (Level III -- Surgical pathology, gross and microscopic examination, skin -- cyst/tag/debridement).Instead: Code the KOH test based on the lab method, your payer, and your lab certification. Typically, a "KOH preparation test" involves placing the skin/nail specimen on a slide with KOH solution and heating the specimen to dissolve the skin and nail cells. The process will leave fungal cells on the slide, if present, and the cells can be seen using a [...]
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