Pathology/Lab Coding Alert

Question: The pathologist receives a lung biopsy from the right lower lobe, a bone biopsy from a surrounding rib, and an intrathoracic lymph node biopsy. How should we bill the pathology exam?

Florida Subscriber

Answer: You should separately bill each biopsy pathology exam. For the lymph node biopsy, report 88305 (Level IV - Surgical pathology, gross and microscopic examination … Lymph node, biopsy). For the rib and lung biopsy exams, report two units of 88307 (Level V - Surgical pathology, gross and microscopic examination … Bone – biopsy/curettings … Lung, wedge biopsy).

Clarify: CPT^® also provides a code for a transbronchial lung biopsy (88305 … Lung, transbronchial biopsy). Although you don’t state the surgical approach, the fact that the pathologist receives a lung, rib, and lymph node biopsy implies that the surgery was either open or by or video assisted thoracoscopic surgery (VATS). Code 88305 describes a small lung biopsy taken through a bronchoscope. You can check the surgeon’s designation to ensure that you choose the proper lung biopsy code.