Pathology/Lab Coding Alert

Question: In the answer to a reader question, Bone Marrow Exam, on page 32 the April 2000 Issue of the Pathology/Lab Coding Alert, the language code 88305 should be used for interpretation of each specimen or cell block has raised an issue in our office regarding our practice of coding blocks.

For example, in a bone marrow aspiration, there is usually a single aspirate; particles are picked and smeared and the remainder is allowed to clot, usually resulting in two or three cell blocks. We have charged as a single specimen, but need three cell blocks.

Similar circumstances arise in pleural ascitic fluid when the entire specimen is spun down resulting in several cell blocks, depending on the size of the specimen. At times, these specimens can be so large they require as many as 12 cell blocks. In each of the above circumstances, we have traditionally charged as one cell block if submitted in one container. Are we treating this situation correctly?

Illinois Subscriber

Answer: For cell block, you use code 88305 (level five surgical pathology, gross and microscopic examination) per cellblock prepared and analyzed by the histology department. The reimbursement is based on the work (each cell block) and not the specimen. If the specimen is large and requires 12 cell blocks in order to determine a diagnosis, code 88305 would be reported with 12 in the unit column. The number of cell blocks billed would have to be justified by the condition and or size of the specimen (medically necessary).