Pathology/Lab Coding Alert

CCI 16.2 bundles 88387 with surgical consult codes.

In case you're having trouble choosing between 88387 (Macroscopic examination, dissection, and preparation of tissue for nonmicroscopic analytical studies [e.g., nucleic acid-based molecular studies]; each tissue preparation [e.g., a single lymph node]) and +88388 (... in conjunction with a touch imprint, intraoperative consultation, or frozen section, each tissue preparation [e.g., a single lymph node] [List separately in addition to code for primary procedure]), CCI 16.2 adds some new edit pairs to clear things up.

+88388 Zeros in on 'Intraoperative'

Because the +88388 definition directs you to use the code in conjunction with "touch imprint, intraoperative consultation, or frozen section," it's the right choice for use with 88329- 88334 (Pathology consultation during surgery ...).

"The +88388 service involves macroscopic tissue exam and  prep, so you can report the code for intraoperative consults that involve gross only or gross and microscopic exams," says Peggy Slagle, CPC, billing compliance coordinator at the University of Nebraska Medical Center in Omaha.

CCI Confirms Code Choice

To ensure that you use +88388 when the pathologist performs the additional molecular diagnostics tissue prep work for an intraoperative consult, CCI 16.2 adds five new edit pairs that bundle 88387 with 88329-88334.

Problem: It wouldn't be unusual for a pathologist to perform an intraoperative touch prep and also carry out a surgical pathology specimen exam such as 88307 (Level V -- Surgical pathology, gross and microscopic examination) on the same day. If the pathologist performs additional macrodissection to prep the 88307 specimen for molecular diagnostics testing, you might be reporting 88333 (...cytologic examination [e.g., touch prep, squash prep], initial site) on the same claim as 88387. But CCI now bundles 88387 and 88333.

Solution: "You should override the edit pair with modifier 59 (Distinct procedural service) because the pathologist performs the work on two distinct specimens," Slagle says.