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toe amputation-bone frag- for crystal analysis

  1. #1
    Default toe amputation-bone frag- for crystal analysis
    Medical Coding Books
    Clinical data is Gout
    1st and 2nd specimens are fragments of 4th toe toe amputation, however the 3rd specimen is a bone fragment of 4th toe and tissue submitted entirely for crystal analysis.
    Final Dx: Negatively birefringent crystals consistent w/ monosodium urate.
    Doctor wants to charge 88305.

    What code can be charged here? Not sure if what was actually performed here was a 89060- Crystal identification-

    Any feedback is greatly appreciated! Thanks!

  2. #2
    Default
    If the bone fragment was examined grossly and microscopically, and a diagnosis was based on that, then this is most accurately described as 88304, a bone fragment other than for pathologic fracture.

    If the entire specimen was processed for 89060, then this was not a surgical pathology specimen.
    WK

  3. #3
    Default
    Thanks for your feedback...
    His response to me was "I DID DO AN ALCOHOL FIXED ANALYSIS OF SLIDE C FOR CRYSTALS AND RESULTS REPORTED AS C/W MONOSODIUM URATE".
    He wants to charge a 88305 for evaluating the crystals on the slide. It sounds to me like a 89060- but he is aware of the 89060 description & says that is not what he performed.

    No bone was examined- so I can't suggest that CPT unfortunately- I've hit a brick wall!

  4. #4
    Default
    This is not an unlisted specimen. If he insists it should be coded 88305, ask him which definition of 88305 is applicable. 88300-88309 refers to tissue(s) submitted for pathologic diagnosis.

    Good luck,
    WK
    Surgical Pathology Coding Blog

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