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Pathology Code for Nail Clippings

  1. #1
    Green Bay, WI
    Default Pathology Code for Nail Clippings
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    Hello, Does anyone know what the appropriate level pathology code (88302-88309) is for gross & microscopic exam of nail clippings? I see this question has been asked before, but I don't see an answer. I'm leaning towards 88304 due to "Skin - cyst/tag/debridement". My rationale for this code is....nails are part of the Integumentary System & nail clippings could possibly be considered a "debridement" (maybe?). Any thoughts?

    Thank you!

  2. #2

  3. #3
    Per Paget's it would be an 88304

    Nail, Nail Bed or Scrapings for Fungal Infection (88304). Clinicians will at times submit a
    nail (fingernail or toenail) or portion thereof (nail bed or scrapings) to pathology for evaluation
    for fungal infection (e.g., onychomycosis). If the pathologist determines that a microscopic exam
    of the primary tissue (nail and/or soft tissue bed) is medically indicated, the work is appropriately
    reported with code 88304 (Level III) according to the AMA. {AMA CPT Information Services,
    letter dated July 9, 2004} A special stain (e.g., PAS) will almost certainly be applied as well to
    determine if fungal infection is present, and code 88312 is separately reported for it. Should the
    nail require decalcification prior to paraffin embedding, report code 88311 for that procedure.
    Obviously, all work (H&E light microscopy, special stain, and/or decalcification) must be
    adequately demonstrated in the pathology report to support the various charges.
    Heads-Up: The pathologist may determine after macroscopically examining the nail, nail
    bed or scrapings that the primary tissue itself doesn’t warrant microscopic examination via H&E
    sections. Instead, he or she will report the primary specimen “gross-only.” Nonetheless, a portion
    of the specimen will be processed for special stain application to determine if a fungal infection
    exists. In this instance, you’d report code 88300 (Level I) for the primary examination and code
    88312 for the special stain. According to the AMA, code 88300 denotes a “primary service” that
    supports a special stain code (88312-88319). {Ibidem}
    Sentinel Lymph Node (88307). The term refers to a sentinel

  4. #4
    Green Bay, WI
    Thank you!

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