Pathology/Lab Coding Alert

Question: Our pathologist examines a kidney biopsy, evaluating some permanent section slides and performing IgG and IgA immunofluorescent antibody studies on frozen sections. Can we code the frozen sections in addition to the biopsy?

Connecticut Subscriber

Answer: You should code the kidney biopsy using 88305 (Level IV -- Surgical pathology, gross and microscopic examination, kidney, biopsy). Although you can bill the antibody studies as an ancillary service, you should not use the frozen section codes to do so.
 
CPT provides 88331 (Pathology consultation during surgery; first tissue block, with frozen section[s], single specimen) and 88332 (- each additional tissue block with frozen section[s]) to describe a consultation between the pathologist and the surgeon while the patient is in the operating room. Don't use the codes for other frozen-section tissue processing that does not involve a consult.

You should report the antibody studies on frozen sections using either 88346 (Immunofluorescent study, each antibody; direct method) or 88347 (... indirect method), depending on the method. Because you perform two antibody studies (IgG and IgA), list two units of the appropriate code.

Reader Questions and You Be the Coder were prepared with the assistance of R. M. Stainton Jr., MD, president of Doctors- Anatomic Pathology Services in Jonesboro, Ark.