Hello, I am a student of CPC. I have a problem on the following question, hope somebody else can help to solve my problem since my examination date is on next week. Many thanks!
Question:
During a craniectomy the surgeon performed a frozen section of a large piece of tumor and sent it to pathology. The pathologist received a rubbery pinkish tan tissue measuring in aggregate 3 x 0.8 x 0.8 cm. The entire specimen is submitted in one block and a microscope was used to examine the tissue. The frozen section and the pathology report are sent back to the surgeon indicating that the tumor was a medulloblastoma. What CPT? code(s) will the pathologist report?
A. 80500
B. 88331-26
C. 80502
D. 88331-26, 88304-26
The official answer is B.
Answer key:
Since the pathology consultation of the tumor is performed during a surgery you are guided to code 88331. Codes 80500 and 80502 are reported according to CPT? guidelines when the pathologist gives a response to a request from an attending physician in relation to a test result(s) requiring additional medical interpretive judgment. The pathologist did not perform the final report of the tumor, eliminating multiple choice answer D. Modifier 26 reports the professional service.
My question is..
According to their answer key, "the pathologist did not perform the final report of the tumor" so the code 88304 will not be assigned. However, in view of the description from the question statement, " The frozen section and the pathology report are sent back to the surgeon indicating that the tumor was a medulloblastoma" the pathologist did provide a pathology report. I wonder if this statement can be considered the reporting of the tumor, which the code 880304 is involved and should be assigned.
Also, is the pathology report different from the "final report"?
And is medulloblastoma under the type of neuroma?
If only code 88331, what about the usage of the microscope? Do we need to code about this separately?
I also find some relevant info about this as follows:
Examples of surgical pathologys
CPT Assistant, July 2000 Pages: 4,12 Category: Coding Update
Clinical Examples
Example #1: A breast biopsy is sent to the pathologist intraoperatively for immediate diagnosis. The pathologist examines the specimen and selects a portion to prepare as a block for frozen section, which is microscopically examined. The frozen section for this specimen is coded using 88331. The definitive evaluation of the breast biopsy is coded using either 88305 or 88307, depending on whether or not the surgical margins of the specimen requires microscopic evaluation.
Example #2: Two separately identified basal cell carcinomas are submitted for diagnosis and evaluation of adequacy of the surgical margins. The first basal cell carcinoma specimen requires one frozen section from one block to confirm the adequacy of excision. The frozen section on the first specimen is coded using one unit of 88331. The second basal cell carcinoma specimen requires two frozen sections on two blocks to assure adequate excision. The first frozen section on the second specimen is coded using one unit of 88331; the second frozen section on this specimen is coded as 88332. Each of the two separately identified basal cell carcinomas is coded as 88305 for definitive examination.
Example #3: In the course of a radical prostatectomy, obturator lymph nodes from the right and left sides are submitted as separate specimens for immediate diagnosis with respect to involvement with metastatic disease. The pathologist examines each of these specimens and selects portions of lymph nodes resulting in two blocks on the right and three blocks on the left for frozen sections which are examined microscopically. The specimen from the right side involving a frozen section on each of the two blocks would be coded using one unit of 88331 and one unit of 88332. The specimen from the left side involving a frozen section on each of the three blocks would be coded using one unit of 88331 and two units of 88332. The right and left obturator lymph node resections would be coded using two units of 88307 and the radical prostatectomy specimen would be coded using 88309.
Question:
During a craniectomy the surgeon performed a frozen section of a large piece of tumor and sent it to pathology. The pathologist received a rubbery pinkish tan tissue measuring in aggregate 3 x 0.8 x 0.8 cm. The entire specimen is submitted in one block and a microscope was used to examine the tissue. The frozen section and the pathology report are sent back to the surgeon indicating that the tumor was a medulloblastoma. What CPT? code(s) will the pathologist report?
A. 80500
B. 88331-26
C. 80502
D. 88331-26, 88304-26
The official answer is B.
Answer key:
Since the pathology consultation of the tumor is performed during a surgery you are guided to code 88331. Codes 80500 and 80502 are reported according to CPT? guidelines when the pathologist gives a response to a request from an attending physician in relation to a test result(s) requiring additional medical interpretive judgment. The pathologist did not perform the final report of the tumor, eliminating multiple choice answer D. Modifier 26 reports the professional service.
My question is..
According to their answer key, "the pathologist did not perform the final report of the tumor" so the code 88304 will not be assigned. However, in view of the description from the question statement, " The frozen section and the pathology report are sent back to the surgeon indicating that the tumor was a medulloblastoma" the pathologist did provide a pathology report. I wonder if this statement can be considered the reporting of the tumor, which the code 880304 is involved and should be assigned.
Also, is the pathology report different from the "final report"?
And is medulloblastoma under the type of neuroma?
If only code 88331, what about the usage of the microscope? Do we need to code about this separately?
I also find some relevant info about this as follows:
Examples of surgical pathologys
CPT Assistant, July 2000 Pages: 4,12 Category: Coding Update
Clinical Examples
Example #1: A breast biopsy is sent to the pathologist intraoperatively for immediate diagnosis. The pathologist examines the specimen and selects a portion to prepare as a block for frozen section, which is microscopically examined. The frozen section for this specimen is coded using 88331. The definitive evaluation of the breast biopsy is coded using either 88305 or 88307, depending on whether or not the surgical margins of the specimen requires microscopic evaluation.
Example #2: Two separately identified basal cell carcinomas are submitted for diagnosis and evaluation of adequacy of the surgical margins. The first basal cell carcinoma specimen requires one frozen section from one block to confirm the adequacy of excision. The frozen section on the first specimen is coded using one unit of 88331. The second basal cell carcinoma specimen requires two frozen sections on two blocks to assure adequate excision. The first frozen section on the second specimen is coded using one unit of 88331; the second frozen section on this specimen is coded as 88332. Each of the two separately identified basal cell carcinomas is coded as 88305 for definitive examination.
Example #3: In the course of a radical prostatectomy, obturator lymph nodes from the right and left sides are submitted as separate specimens for immediate diagnosis with respect to involvement with metastatic disease. The pathologist examines each of these specimens and selects portions of lymph nodes resulting in two blocks on the right and three blocks on the left for frozen sections which are examined microscopically. The specimen from the right side involving a frozen section on each of the two blocks would be coded using one unit of 88331 and one unit of 88332. The specimen from the left side involving a frozen section on each of the three blocks would be coded using one unit of 88331 and two units of 88332. The right and left obturator lymph node resections would be coded using two units of 88307 and the radical prostatectomy specimen would be coded using 88309.