Reader Question:
Pathology Specimens
Published on Wed Mar 01, 2000
Question: We received specimens that include the lobe of a lung and different level biopsies associated with it. The diagnosis for the lung is squamous cell carcinoma, and the level biopsies include a) lymph node, b) parathyroid, c) thyroid tissue. In addition to lung biopsy, should we code for these lymph node biopsies or a lymph node, a thyroid biopsy and a parathyroid biopsy?
Vipul A. Trivedi, MD
Department of Pathology Laboratory
Luther Hospital, Eau Claire, Wis.
Answer: These are not tissues that are considered bundled. Unless the surgical notes indicate that the associated tissues are incidental, we suggest you code each specimen separately.
The medical record should reflect the need for diagnosis of each specimen, and the pathologists report should discuss each specimen individually. The lobe of the lung would be coded 88309 (lung-total/lobe/segment resection). The lymph node and the parathyroid are coded 88305 (surgical pathology, gross and microscopic examination; lymph node, biopsy) and (parathyroid gland). The thyroid tissue would be 88307 (surgery pathology, gross and microscopic examination; thyroid total/lobe).
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