Pathology/Lab Coding Alert

Question: Our pathologist received a container labeled "bone and tissue, left hip." It consisted of one femoral head with a focal erosion area and multiple irregular bone fragments and a fibrous tissue fragment. After decalcification, the pathologist's final diagnosis was "bone and adjacent articular cartilage with changes of degenerative joint disease." How should we code the case?Iowa SubscriberAnswer: The correct coding is 88304 (Level III -- Surgical pathology, gross and microscopic examination, femoral head, other than fracture) and +88311 (Decalcification procedure [List separately in addition to code for surgical pathology examination]). The correct diagnosis code is 715.95 (Osteoarthrosis, unspecified whether localized or generalized, pelvic region and thigh).Although the specimen is almost certainly from hip replacement surgery, you should not use the code for joint resection (88305, Level IV -- Surgical pathology, gross and microscopic examination, joint, resection).Here's why: Unlike a knee replacement, which involves bone from both sides of the joint, a [...]