Pathology/Lab Coding Alert

Question: Our pathologist received a partial nephrectomy specimen and a separate container with four nearby retroperitoneal lymph nodes. The pathologist describes the kidney exam and the lymph node exam in the report and indicates that the service is 88307. Is the lymphadenectomy bundled with the 88307 nephrectomy service?

Ohio Subscriber

Answer: No, you would not typically bundle pathology exam of lymph node resection with a nephrectomy. CPT^® lists some specific pathology specimens that include associated lymph nodes, and convention dictates that “attached” lymph nodes are commonly part of other specimens, but a kidney specimen does not fall under either of those bundling expectations.

If the pathologist documents microscopic exam and findings for both the nephrectomy specimen and for the partial lymphadenectomy that was separately submitted, you should be able to bill for both services using the following two codes:

88307 (Level V - Surgical pathology, gross and microscopic examination … Kidney, partial/total nephrectomy…)

88307 (… Lymph nodes, regional resection …).