Jennifer Johnson asks: >>Today we received one container labelled 'sentinel nodes' for frozen section. There were five nodes and they were placed in two chucks. How in the heck are we to know how to code for charges for this? Is it per container, per node, or per frozen? Plus, is there a person or agency that you can call to ask these questions?<<
and Joyce Weems replies: >>This would be one specimen, [if] the nodes were not separately identified. You would charge an 88331 for the first block and 88332 for the second block.<< If the lymph nodes were separately identified, say, "sentinel node #1" through "sentinel node #5" then if you separated them from each other (say by marking them with different colored inks) then you could bill for five specimens, five frozen section codes 88331 and five specimen codes 88305. The final pathology report would have to identify them, say, 1. left axillary lymph node (sentinel node biopsy #1): Reactive hyperplasia. No malignant tumor identified. 2. - and so on through 5. Parenthetically, you shouldn't be doing frozen sections on grossly negative sentinel lymph nodes - it loses too much tissue. Touch preparations suffice. I don't know of any hot line for problems like this. Most of them are covered in the CAP Web site resource on the subject, if you can find it. It's quite chaotic, and it's worth reading it through and abstracting it on a slow day. These adjudications - which unfortunately are no longer done - are considered authoritative by the authorities. Here you read, for example, that a twin placenta is two codes 88307 iff you can identify cord A and cord B (doesn't matter how the identification is done). Bob Richmond Samurai Pathologist Maryville TN _______________________________________________ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet