Pathology/Lab Coding Alert

Question: What is the correct procedure code for right salpingo-oophorectomy with a diagnosis of fallopian tube serous cystadenofibroma?

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Answer: The best code choice is 88307 (Level V - Surgical pathology, gross and microscopic examination …). Because the cancer is in the fallopian tube, not the ovary, this specimen may be considered “unlisted” for purposes of pathology exam coding.

Here’s why: Code 88307 lists as a specimen, “ovary, with or without tube, neoplastic,” which is similar to the specimen you’ve described (salpingo-oophorectomy). But the cancer is in the tube, not the ovary, so the code definition doesn’t fit your case exactly.

On the other hand, 88305 (Level IV - Surgical pathology, gross and microscopic examination …) lists the following specimens:

• Fallopian tube, biopsy
  
• Fallopian tube, ectopic pregnancy
  
• Ovary with or without tube, non-neoplastic
  
• Ovary, biopsy/wedge resection.
  

None of these listed specimens fit the exact scenario you describe, either.

Bottom line: For an unlisted surgical pathology specimen, CPT® instructs that you should select the code “which most closely reflects the physician work involved when compared to other specimens assigned to that code.” In this case, the closest listed specimen is a neoplastic ovary with fallopian tube, which is comparable to an ovary with neoplastic fallopian tube.