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88305 or 88307

  1. Default
    Exam Training Packages
    I love all that has happened, but my question was really this, if you have a mass growing on your kidney and you take a bx of that mass ( cancerous tumor) are you taking a biopsy of that site ( the kidney) or are you really just taking a biopsy of the tumor ( soft tissue mass) that grew on that site.

    After reading Dennis Paget ( hopefully you have heard of him), he says go with the soft tissue only when you can more specifically go with the site so...
    looks like 88302 (ha ha ha , just kidding, would have to go with 88305)

  2. #12
    Default
    DP's the gold standard though we don't always agree. That's more a matter of nuance than fundamentals. It's not undifferentiated soft tissue, it's kidney despite what it may have morphed into. That's why kidney bx is the best description. Soft tissue applies when you have something that isn't otherwise defined by CPT (an organ usually). It doesn't really matter if the mass is cancerous tumor or fibroma or bumpkiss, it's kidney in this case so you code 88305.

    Yeah, who knew this would spin out the way it did? All the threads should be like this. We'd learn a lot more of what's going on outside our offices!!!

  3. #13
    Location
    Frederick, MD
    Posts
    270
    Default
    Before you throw the baby out with the bath water, (Carol Buck) read her pubkication for yourself. You are stating you don't want to know her based on something someone else said.

    Also it's obvious that a kidney bx is an 88305. Just read the CPT book.

    Always Seeking

  4. #14
    Default
    Good advice, Just Another Coder. I will check out Carol Buck to get it straight from the source. You're also right that if it's in CPT, that's the real gold standard.

    Sound words we should all keep in mind.
    Thanks,
    WK

  5. #15
    Default Kidney Mass BX
    Well, Carol Buck is well known to may seasoned coders. she writes course books for several online schools. I believe she works for the AMA. Google her on the website.

    I believe the level for this biopsy examination, no matter what title you give it, it is the services performed, the location, etc. that will determine the level. This is definitely a higher level than 88305.

  6. #16
    Default
    I googled her and realized that I've used her books for teaching. 88305.

  7. Cool
    I do tell my coders to go by the code books as the golden rule, but many times it does feel very wrong. An example of this would be when a pt has gallbladder cancer, and the pathologist sections the gallbladderand ends up with slides from A to ZZ( so now he is reviewing 48 slides) , this in no way should be 88304, but we code it that way just the same. ( i realize this codes probably work out better if you are a small path office, but when you are an extremely large practice, not so much)

    have a great day.
    and I two have both heard of and read carol buck, but not for pathology, but would like to see this.( what is the name of this book??)

  8. #18
    Default
    Well, you have to remember that the codes don't describe the amount of work but the specimen at hand. If it's a gallbladder, it's a gallbladder and CPT doesn't make any distinction. It's like those big, deep skin excisions for invasive melanoma. It's skin other than cyst, tag, debridement or repair. It is what it is. The codes are assigned for the average not the outlying difficult case. The idea is, I think, that you get so many easy ones that are a snap that they'll pay for the hard ones that suck up a lot of time and resources.

    We always complain about the cancerous gallbladder and appendix (88304) but we're content with a soft tissue mass that turns out to be nothing (88307). We're not reporting how many supplies and how much time and professional expertise we expend, only what we examine and diagnose. It all comes out in the wash.

    I agree. Follow the code books literally and you'll never go wrong or worry during an audit. Follow unofficial resources with caution no matter what credentials they have or how many books they've published. Nobody is an expert when it comes to pathology coding because it's all fuzzy. If you rely on CPT, you have at least one leg to stand on.

    Cheers.
    WK
    http://pathcoder.blogspot.com
    Last edited by whaleheadking; 08-26-2010 at 04:56 PM.

  9. Default
    I totally agree !!!

  10. #20
    Location
    martinez ca
    Posts
    11
    Default
    technically the mass is a soft tissue and its not the kidney being biopsied but rather the mass so i would use 88307

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