Pathology/Lab Coding Alert

Question: Our pathologist examined a large (13 cm x 6 cm) skin excision from a patient’s upper arm. The surgeon oriented the specimen with a suture at 12 o’clock and identified a specific “suspicious” margin at 4 o’clock. Can we bill this exam as 88307?

California Subscriber

Answer: No, you should not bill a skin specimen as 88307 (Level V - Surgical pathology, gross and microscopic examination), no matter how large or complicated the specimen.

CPT® lists specific tissue specimens under the surgical pathology codes 88302-88309, and you need to assign the code based on the listed specimens. Only if the tissue is not listed under any of those codes are you allowed to assign the surgical pathology level yourself.

In this case, the skin specimen you describe is listed under 88305 (Level IV - Surgical pathology, gross and microscopic examination, Skin, other than cyst/tag/debridement/plastic repair).

If your pathologist documents that the specimen took extra time and significantly extra work (such as far more blocks and slides than for a typical 88305 skin specimen), you might be able to list the code with modifier 22 (Increased procedural services).