Pathology/Lab Coding Alert

Question: Our pathologist examines a colon resection with a final diagnosis of Crohn's disease but wants to code 88309 because he says the exam involves looking "for tumor," which matches 88309's description.

Tennessee Subscriber

Answer: CPT provides two codes for a colon resection: 88307 (Level V -- Surgical pathology, gross and microscopic examination, colon, segmental resection, other than for tumor) and 88309 (Level VI -- Surgical pathology, gross and microscopic examination, colon, segmental resection for tumor, or - colon, total resection).

You should only report 88309 if the pathologist examines a total colon resection with any diagnosis, or a segmental colon resection that involves a cancer diagnosis. If the surgeon removes the section of colon for Crohn's and the pathologist diagnoses cancer, you can report 88309.

Red flag: You should report 88307 -- not 88309 -- for your example because the final diagnosis is Crohn-s, not cancer. The specimen fits the definition "other than for tumor."

-- Reader Questions were prepared with the assistance of R.M. Stainton Jr., MD, president of Doctors- Anatomic Pathology Services in Jonesboro, Ark.