# Uterus w/Placenta CPT



## kate8 (Aug 17, 2010)

I am looking for some help with CPT Pathology codes for this scenario. I have a case where they performed a C-section, and removed the Uterus at that time. The specimen is in one container, but the the Diagnosis includes a DX of the Placenta as well as the Uterus. Is the Placenta separately chargeable (ie. 88307x2)?

"UTERUS", (CAESAREAN HYSTERECTOMY):

 - UTERUS AND PLACENTA, 780 G, APPROPRIATE FOR GESTATION.
 - ADHERENT PLACENTA PERCRETA, EXTENDING THROUGH FULL
   THICKNESS OF LOWER ANTERIOR UTERINE WALL.

 - LOWER SEGMENT WITH FOCAL ENDOCERVICAL-TYPE LINING, NO
   ECTOCERVIX IDENTIFIED.
 - SCANTY DECIDUALIZED ENDOMETRIUM IDENTIFIED IN UPPER
   UTERINE SEGMENT.
 - MYOMETRIUM WITH FOCAL LEIOMYOMA (3.5 CM).
 - UTERINE SEROSA, HISTOLOGICALLY UNREMARKABLE.
 - NO EVIDENCE OF MALIGNANCY.

 - THREE VESSEL UMBILICAL CORD, HISTOLOGICALLY UNREMARKABLE.
 - ATTACHED MEMBRANES WITH PIGMENT LADEN MACROPHAGES.
 - ACUTE SUBCHORIONITIS, MILD. 
 - VILLOUS DEVELOPMENT APPROPRIATE FOR GESTATION.
 - MULTIFOCAL INTERVILLOUS HEMATOMAS/THROMBI.


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## preserene (Aug 17, 2010)

I do not under stand what is meant by separately chargable. Any way, in this condition, it is not because it has become a part and parcel of the( antepartum and so postpartum) uterus; lik e the roots of a tree being established in to the soil.
The pathologist will separate it in 'piecemeal sections'

Adherent placenta: types are accreta , increta and percreta. The percreta type is the one  not only adherent and has invaded into the uterus(myometrium) completely that it is not separable by any means but inevitably going for ( Cesarean Hysterectomy) Hysterctomy 
Percreta with hemorrhage-  *666.02. 666.04 , 666.00*. this is more appropriate for the increta placenta
667.0x with out hemorrhage;  
CPT:  59510-59515 (any one as as it suits the global) PLUS 59525


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## preserene (Aug 17, 2010)

Yes the Pathology code is 88307.  I understand the specimen, to be separately viewed grossly and microscopically is mandatory for the pathologist. so when it comes to his coding both has to be separately coded. Both belong to the 88307 level of coding. As you said, for my openion, it should be 88307 into 2.


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## kate8 (Aug 17, 2010)

Thank you!


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