Wiki gastrectomy for morbid obesity

[JEWEL2010]

Hello to all,

We have a case for a sleeve gastrectomy with no diagnostic changes performed for morbid obesity.
Our pathologist feels a 88307- "stomach , subtotal/total resection, other than for tumor" does not closely reflect the level of work, mainly because it was normal gastric tissue.
He feels charge should be level of work = 88305.

What is anyones take on this topic? thank you in advance!

 

[whaleheadking]

The unit of service is the specimen. 88307 accurately describes the tissue at hand: a subtotal resection of stomach other than for tumor. It is not a biopsy, so 88305 does not apply.

WK

Pathology Coding Blog

 

[JEWEL2010]

That seems to be the concensus, thank you for your feedback.

 

[whaleheadking]

Surgical Pathology specimens are not assigned codes according to the amount of work involved. If you interpret the definition of the specimen literally, you will be able to justify the code assigned to the specimen. It is when labs start to hedge according to criteria other than what CPT specifies that their codes and associated charges start to become a mishmash of things that cannot be substantiated by the methodology that CPT requires, along with the documentation, to describe the work performed for the specimens submitted. Some specimens require more work, some less. The specimen is the unit of service, not the evaluation and management, in Surgical Pathology setting.

Professional bodies have qualified this rule in certain instances, and those qualifications make sense when a coder considers the scope and logic of CPT's methodology in assigning codes in the 88300-88309 range.

WK
Surg Path Coding Blog.