Pathology/Lab Coding Alert

Answer: No, you should not upcode a tongue biopsy specimen because the diagnosis is a malignant tumor.

The correct code for the tongue biopsy is 88305 (Level IV - Surgical pathology, gross and microscopic examination … tongue, biopsy…).

CPT^® does not list tongue as a surgical specimen under 88307 (Level V - Surgical pathology, gross and microscopic examination…). Although tongue is a listed specimen under 88309 (Level VI - Surgical pathology, gross and microscopic examination … tongue/tonsil resection for tumor …), the code descriptor does not match your description of the specimen as a tongue core biopsy.

Key: You must base your surgical pathology code selection based on the specimens listed under each code 88300-88309. Only if the specimen is not listed are you allowed to assign a code based on the level of work involved in the procedure.