Wiki Coding #88305 with deeper tissue sections

[CatchTheWind]

We code gross and microscopic examination of skin biopsies is #88305. Sometimes the pathologist documents that he also examined deeper tissue sections. One of our coders tells me that she was instructed by her trainer that when this is the case, she is to code #88305 and #88342.

This makes no sense to me, and I wonder if anyone is aware of any logic to this? If not, is there a another code (or a modifier) to use when deeper tissue is also examined?

 

[bbooks]

You are correct, 88342 (Immunohistochemistry, each separately identifiable antibody per block, cytologic preparation, or hematologic smear; first separately identifiable antibody per slide) cannot be used for deeper sections. I think this is just part of the cost of doing business. The only time we code a charge for deeper cuts is with consults, when the specimen and slides that were sent require additional slides made to make the diagnosis. This situation changes the consult code from 88321 to 88323.

Do others agree?

 

[CatchTheWind]

Thanks for your reply. I have since heard from a pathologist that, as you said, examining deeper tissue is just "the cost of doing business" and there is no additional code you can bill for (unless there is a PAS stain, in which case you can add 88312).

 

[danachock]

88305 is the only thing billable unless the pathologist states that they use a certain stain in their pathology. Most of the time that charge will drop when your pathologist drops the charge for your pathology (gross & microscopic).