# Coding DX in Pathology



## rlmarkow (Nov 10, 2008)

Does anyone know of a class or book regarding PC of Pathology specimens?
There must be some rules out there besides "code to the highest specificity".....

Any direction is greatly appreciated.  Thanks!

Rhonda


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## epilcher (Nov 11, 2008)

rlmarkow said:


> Does anyone know of a class or book regarding PC of Pathology specimens?
> There must be some rules out there besides "code to the highest specificity".....
> 
> Any direction is greatly appreciated.  Thanks!
> ...




Rhonda,

I am a coder for a Pathology lab and this is what I do for DX codes.  When the pathologist diagnoses a specimen, I use the pathologists diagnosis.  When the result is normal, I use the signs/symptoms for the tests.  In some cases, I use both based on the amount of specimens on the case and if some results are mixed.  

I hope this helps


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## rlmarkow (Nov 12, 2008)

*dx in pathology*

Thanks for the info.......I am concerned with benign lymph nodes when there is breast cancer, and the benign margins.....

also...for a screening colonoscopy, when there is some benign tissue....medicare will not pay for the screening code.....what do you use?  

Thanks for your help

Rhonda


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## epilcher (Nov 12, 2008)

rlmarkow said:


> Thanks for the info.......I am concerned with benign lymph nodes when there is breast cancer, and the benign margins.....
> 
> also...for a screening colonoscopy, when there is some benign tissue....medicare will not pay for the screening code.....what do you use?
> 
> ...




This is the way I see it:

When they are talking a lymph node biopsy to see if the breast cancer has spread, I use the breast cancer code.  Simply because the medical justification for the lymph node biopsy was because they have breast cancer.  Usually, the provider will include indications for the biopsy.  It might be helpful to check their requisition.

Medicare will not pay for a screening colonoscopy.  I've come by this at my lab and usually when a doctor takes out a colon biopsy is because they found something during the procedure.  When that happens, it goes from screening to medical.  Most of the time they'll see a polyp or something. Code for those. 

Let me know if you have anymore questions. 

Lizzy


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