Pathology/Lab Coding Alert

Question: When the pathologist examines a placenta with the request to look for signs of abnormality such as infection, abruption, hypertension, infarction, etc., how should we code the work and the diagnosis, particularly if the placenta is normal?

Connecticut Subscriber

Answer: The proper procedure code for the pathologist's placenta exam depends on the gestational age. Select one of the following codes:

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

For a placenta showing no pathology (normal), you should use the ICD-9 code that describes the delivery conditions such as one of the following:

• 650 -- Normal delivery
• 669.7x -- Cesarean delivery, without mention of indication
• 644.2x -- Early onset of delivery.

On the other hand, if the placenta demonstrates pathology you should select a code that describes the abnormality such as one of the following:

• 658.4x -- Infection of amniotic cavity (placentitis)
• 656.7x -- Other placental conditions (abnormal placenta, placental infarct)
• 667.xx -- Retained placenta without hemorrhage
• 710.1 -- Systemic sclerosis (Chorionitis)
• 641.2 -- Premature separation of placenta (Abruptio placentae).