Wiki Single Tissue - 2 Containers - 1 or 2 specimens?

[hara.steph@gmail.com]

Our physicians' group recently started coding/billing pathology services. We have a scenario that keeps getting different answers from different people:

A single tissue specimen was taken. The specimen was divided into 2 pieces and put in 2 separate containers. One container sent for gross examination only (CPT 88300) and the other for gross and microscopic examination (CPT 88305). Because it started with the same tissue, one opinion is that both containers should be coded using only CPT 88305 x1 but another opinion is that because they were in separate containers it should be billed as CPT 88300 x1 and CPT 88305 x1.

Would someone with experience in pathology coding/billing please be able to offer some guidance with this?

Thank you!

 

[ellzeycoding]

In the 2017 CPT Book, page 571 under the heading Surgical Pathology it states...

"The unit of service for codes 88300 through 88309 is the specimen"

So it doesn't matter if it's cut into 100 pieces or 1, it's one specimen. You bill one unit.

Same things with making slides. If you make 6 slides from one piece of tissue, you still only bill one unit/specimen.

 

[whitney1802]

I would have to say bill them seperately, 88300 x 1 and 88305 x 1.
"A specimen is defined as tissue or tissues that is (are) submitted for individual and seperate attention, requiring individual examination and pathologis diagnosis." Which is what this case would be. That came from 2018 CPT book.