Pathology/Lab Coding Alert

Question: The pathology report documents a 2.1 cm “cherry hemangioma,” from the patient’s right thigh, and I’m uncertain if this is a type of cancer. What are the correct CPT^® and ICD-10 codes for the case?

Illinois Subscriber

Answer: A cherry hemangioma is a benign integumentary lesion made up of clusters of capillaries forming a dome-shaped, red to purple mass — typically on the surface of the skin.

That means you should report the pathology exam of the specimen as 88305 (Level IV - Surgical pathology, gross and microscopic examination … Skin, other than cyst/tag/debridement/plastic repair …). Notice that the CPT^® coding doesn’t depend on whether this is a type of cancer — just that it’s a skin specimen that is not a cyst, tag, or tissue from debridement or plastic repair. Other than those exceptions, 88305 describes the pathologist’s exam of all skin specimens regardless of size and diagnosis.

ICD-10: To assign the correct diagnosis code, the pathology report should document the cherry hemangioma site on the patient’s body. With that info, you can select the most specific code from the following choices:

• D18.00 — Hemangioma of unspecified site
• D18.01 — … of skin and subcutaneous tissue
• D18.02 — … of intracranial structures
• D18.03 — … of intra-abdominal structures
• D18.09 — … of other sites.

For the case at hand, you would select D18.01 for the cherry hemangioma on the patient’s thigh.