CMS

Why Must CMS Overreach on Rules?

Joseph Goedert Health Data Management Blogs, September 2, 2011 To prove meaningful use of electronic health records, providers must collect, organize and report data culled from certified electronic health records…

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October 10, 2011
Coding Challenge / pathology

Medical Coders: Focus on Fibroid Diagnosis

Find out why you should code the pathology exam of uterus with leiomyomas as 88307.

Question: When our pathologist diagnoses uterine fibroid tumors, what ICD-9 code should we use?

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Answer: You should choose the diagnosis based on the fibroid’s location:

  • Submucous fibroids (218.0, Submucous leiomyoma of uterus) grow from the uterine wall toward the uterine cavity. They are also called intracavitary fibroids.
  • Intramural fibroids (218.1, Intramural leiomyoma of uterus) grow within the uterine wall (myometrium). They are also called interstitial fibroids.
  • Subserous fibroids (218.2, Subserous leiomyoma of uterus) grow outward from the uterine wall toward the abdominal cavity. They are also called subperitoneal fibroids.
  • If the physician does not specify the uterine fibroid’s location, assign 218.9 (Leiomyoma of uterus, unspecified) as the diagnosis.

CPT alert: You should code the pathology exam of uterus with leiomyomas as 88307 (Level V — Surgical pathology, gross and microscopic examination, uterus, with or without tubes and ovaries, other than neoplastic/prolapse).

Although ICD9 classifies leiomyoma as a benign neoplasm, a coding convention supported by the American Medical Association and the College of American Pathologists dictates that you code this condition as 88307, not 88309 (Level VI — Surgical pathology, gross and microscopic examination, uterus, with or without tubes and ovaries, neoplastic).

For myomectomy specimens — fibroid tumors that the surgeon removes while leaving the uterus intact — bill the pathology exam as 88305 (Level IV — Surgical pathology, gross and microscopic examination, leiomyoma[s], uterine myomectomy — without uterus).

@ Pathology/Lab Coding Alert. Editor: Ellen Garver, CPC

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May 27, 2010
CCI / Hot Coding Topics / pathology

Pathology Billing: Calculate How MUE/CCI Restricts Your Outside Consult Pay

Don’t bank on accepted 88321-88323 unit of service. Your pathologist consults with an outside lab on slides taken from a 2006 lumpectomy and a 2009 lymph node fine needle aspiration (FNA). That’s 88321 x 2 — right? Maybe. Your payer determines the answer to that question. The problem: “Although the American Medical Association (AMA) says the unit of service for [...] Related articles:

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January 17, 2010