Laboratory Question for the Week of December 30, 2024

Question:

What is the historical code used for reporting the gross and microscopic examination of prostate core biopsy specimens, and how was it applied?

Answer:

Typically, this surgical service entails the identification and taking of 20 to 40 core samples from the prostate under general anesthesia. Specimens are then submitted to the pathologist for gross and microscopic examination, which has historically been coded per core sample with 88305. To correlate with this change in coding of the surgical procedure, CMS developed and released four separate HCPCS codes (G0416–G0419) for reporting the gross and microscopic examination of separately identified and submitted prostate needle biopsy specimens from a saturation biopsy sampling procedure. However, these codes continued to create confusion and so effective January 1, 2015, CMS deleted HCPCS codes G0417–G0419 and revised the description for G0416 to remove reference to the number of specimens.

This question was answered in our Coding Essentials for Laboratories. For more hot topics relating to laboratory services, please visit our store or call us at 1.800.252.1578, ext. 2.