Pathology/Lab Coding Alert

Question: Our pathologist examined a specimen identified as a kidney stone and ordered an infrared analysis. What are the diagnosis and procedure codes for this case?

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Answer: The correct procedure code is 88300 (Level I - Surgical pathology, gross examination only) for the pathologist’s macroscopic exam of the specimen to identify the calculus. For the infrared analysis to identify clinically significant crystalline componentsof the calculus, report 82365 (Calculus; infrared spectroscopy).

ICD-10 provides a long list of calculi codes, and choosing the proper code depends on knowing the location of the stone within the urinary tract. In this case, because the pathologist identified this as a “kidney stone,” the best code would probably be N20.0 (Calculus of kidney).

You can see that you have several other codes to choose from if you have a urinary tract stone or multiple stones from different sites (including kidney) or from an unspecified site. You would choose the appropriate code from the following list:

• N20.0, Calculus of kidney
• N20.1, Calculus of ureter
• N20.2, Calculus of kidney with calculus of ureter
• N20.9, Urinary calculus, unspecified
• N21.0, Calculus in bladder
• N21.1, Calculus in urethra
• N21.8, Other lower urinary tract calculus
• N21.9, Calculus of lower urinary tract, unspecified.