Pathology/Lab Coding Alert

Question: Our pathologists are receiving more routine hysterectomies with bilateral fallopian tubes. The physician submitting the specimen says he is performing prophylactic salpingectomies to rule out tubal intraepithelial carcinoma. The pathologist sections the fallopian tubes and examines them extensively, including the entire fimbriated end. Can we code separately for the salpingectomies?

Kansas Subscriber

Answer: No, you should not generally bill an additional code for the salpingectomies with routine hysterectomy. The correct code for the specimen is 88307 (Level V - Surgical pathology, gross and microscopic examination … Uterus, with or without tubes and ovaries, other than neoplastic/prolapse…). You should not additionally report the bilateral salpingectomy with a code such as 88305 (Level IV - Surgical pathology, gross and microscopic examination, … Fallopian tube biopsy … or … Ovary, with or without tube, non-neoplastic…).

Because the hysterectomy code states “uterus, with or without tubes and ovaries,” the fallopian tubes are bundled with the hysterectomy specimen and are not separately reportable, regardless of the level of work involved.

Exception: If the pathologist identifies a distinct pathology in the salpingectomy specimen and documents the diagnosis and the work involved in evaluating the specimen, the procedure may warrant a separate code.