kate8
Networker
I code for a pathology department, and see many hysterectomy cases. Very often the report lists the tubes and ovaries separate from the Uterus (ie; specimen 1: R Tube and Ovary; specimen 2: L Tube and Ovary; specimen 3: Uterus). Padget says they must be bundled together if "significant pathology" is not expected or found in the tubes or ovaries, but I cannot find a definition of "significant pathology". Many times the tubes and/or ovaries will have follicle, or paratubal cysts - would this be considered significant enough pathology? And if the patient has a history of endometiral cancer, would this fall into the "significant pathology expected" category?
I understand that if any other tests are done on the specimen (ie, frozen sections, etc) can determine whether they are coded separately. But my question is about about what would be considered "significant pathology" if all these other issues are not present.
On a stand alone ovary/tube, serous cystadenoma or teratoma would be considered sig. pathology and thus an 88307 and separately chargeable, and that serous cyst is not neoplastic so thus 88305. But with a hysterectomy and salpingo-oophorectomy, is serous cyst significant enough to charge separately? And what about follicle derived cysts or paratubal cysts? These are not neoplastic, but I don't know if they would be considered significant enough to warrant having the ovary/tube coded separately from the Uterus.
Any thoughts, feedback?
Thank you!
I understand that if any other tests are done on the specimen (ie, frozen sections, etc) can determine whether they are coded separately. But my question is about about what would be considered "significant pathology" if all these other issues are not present.
On a stand alone ovary/tube, serous cystadenoma or teratoma would be considered sig. pathology and thus an 88307 and separately chargeable, and that serous cyst is not neoplastic so thus 88305. But with a hysterectomy and salpingo-oophorectomy, is serous cyst significant enough to charge separately? And what about follicle derived cysts or paratubal cysts? These are not neoplastic, but I don't know if they would be considered significant enough to warrant having the ovary/tube coded separately from the Uterus.
Any thoughts, feedback?
Thank you!
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