Pathology/Lab Coding Alert

Question: Our pathologist examines specimens labeled "right sentinel node # 1" and "right sentinel node # 2" during surgery. He performs a squash prep from each node to provide immediate evaluation for presence of cancer cells. Should we code this as 88333 x 2 or 88333 and 88334?

Michigan Subscriber

Answer: You should report the service as two units of 88333 (Pathology consultation during surgery; cytologic examination [e.g., touch prep, squash prep], initial site). Reporting the second node as 88334 (...cytologic examination [e.g., touch prep, squash prep], each additional site) would not be correct.

Here's why: If you have two distinct specimens, as in this case, the squash prep you describe is the "initial site" for each specimen. You'll only use the "each additional site" code if the pathologist examines more than one preparation from a single specimen.

For instance: If the pathologist examined one touch prep from sentinel node # 1 and two squash preps from different surfaces of sentinel node # 2, you would report 88333 x 2 plus 88334.