Question Pathology specimen from EMR and/or TAMIS (TEM)


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Hello all,

We recently added a new Surgical Pathology source for specimens obtained via EMR to be CPT 88309. Per Paget given the correct circumstances and final diagnosis this is warranted because this specimen can represent (in smaller tissue amounts) a resection.
I am being asked now about specimens obtained using the TAMIS (TEM) procedure. While Paget does not specifically include these specimens in the handbook, I can see how this can be a similar situation.

I am wondering about others thoughts and impressions. I can see how this could become an auditing nightmare if not closely monitored.

Thank you for your help,
Laura Lattanzio


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Hi, Laura,

We use the same protocol for TEMS that we do for EMR. If the pathologist documents the work performed (i.e. margins, inked and pinned out) we typically give the specimen an 88307. If the specimen has everything listed prior and is malignant, we use 88309.

"The referring physician may at times claim that the specimen that for all intent and purposes is a polypectomy was obtained by or represents an endoscopic mucosal resection. The surgical approach, even if it truly was EMR, doesn’t govern the pathologic exam CPT code. The specimen must, in the judgment of the responsible pathologist, be more than a simple benign or neoplastic polyp to warrant a charge code above the 88305-level; for example, it must have the characteristics of a resection for tumor (albeit, perhaps, a relatively small piece of tissue), including surgical margins for microscopic examination."

Hope that helps some,
Natasha Kovar