Pathology/Lab Coding Alert

Reader Question:

Pathological Diagnoses

Question: How do I code specimens with no pathological diagnoses, especially when the procedure is performed to rule out something?

K. Laukahandra, MD
Kansas City, Mo.

Answer: If specimens have no pathological diagnoses, you must look to the reason for the procedure. When a physician requests a service to rule out a disease, there must be a symptom or reason present for the physician to request a pathological examination of body material (excision or smear). You would code the reason for the service, for example, a mass.