A question was brought up by one of our pathologists concerning lymphoma workups for needle core biopsies vs biopsy – We have been upcoding lymph node biopsies for lymphoma work ups to an 88307 but for the needle core biopsies, we have been keeping them as an 88305. The pathologist looked through Paget’s and couldn’t find any reasoning as to why we should keep a needle core to a 305 – I have included the email for better clarity – Anyone have any thoughts on this?
"Do you recall the reasoning for that? From my reading, I believe we should code 88307 for lymphoma work-up any time flow is done on the same node and/or IHC (to evaluate for a lymphoma) is done both of which were done on this specimen. I didnt see anything in the coding services handbook that would indicate whether it is a core biopsy vs excisional biopsy would make any difference.
The extra work that must be documented will include
at least one of the following: touch preparation or frozen section to assess specimen adequacy
and determine what, if any, special studies are appropriate; H&E sections beyond the number
typically associated with a lymph node biopsy; flow cytometry immunophenotyping; molecular
pathology; and/or immunohistochemistry."