Pathology/Lab Coding Alert

Question: If we receive a twin placenta in two separate containers can we charge 88307 x 2?

Vermont Subscriber

Answer: You might be able to separately report the pathologist’s exam of twin placentas in some cases. The code selection will depend on the gestational age.

CPT^® provides the following two codes for pathology placenta exam:

• 88305 (Level IV - Surgical pathology, gross and microscopic examination …Placenta, other than third trimester…)
• 88307 (Level V - Surgical pathology, gross and microscopic examination …Placenta, third trimester…).

Distinct specimen: Because CPT^® defines a surgical pathology specimen as “tissue or tissues that is (are) submitted for individual and separate attention, requiring individual examination and pathologic diagnosis,” each separately identified placenta warrants an 88305 or 88307 charge depending on the gestational age.

You describe a case in which the pathologist receives the placentas in separate containers. That is one way that the ob-gyn may identify two separate specimens. Another way to distinguish separate specimens may be a suture or ink mark with the ob-gyn’s description distinguishing the placenta for “baby A” and the placenta for “baby B.”

As long as the ob-gyn separately identifies the specimens in some way and your pathologist documents individual examination and diagnosis of each placenta, you can separately code each procedure.