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Pathology/Lab Coding Alert

Reader Question:

Pathololgic Fracture Leads Choice

Published on Mon Sep 10, 2012

Question: According to the surgical report for a knee resection, a patient diagnosed with Padget's disease presented with a fractured knee that was misshapen from bone overgrowth. The surgeon submitted the specimen in fragments, which our pathologist examined and confirmed the diagnosis based on characteristic Padget's mosaic pattern on H&E slides. Should we code the exam as 88305 for joint resection or 88307 for pathologic fracture?Texas SubscriberAnswer: The pathologist should make the call in this case, but it appears that 88307 (Level V - Surgical pathology, gross and microscopic examination, Bone fragment[s], pathologic fracture) is the better choice for the situation you describe.Other choice: The specimen involves a joint resection, and CPT® provides a code for that (88305, Level IV - Surgical pathology, gross and microscopic examination, joint, resection). Whether the pathologist receives the joint in fragments or not would not normally affect your code selection.The overriding condition for this [...]
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