Billing for Surgical Pathology Procedures Related to Abortions

Effective for dates of service on or after February 01, 2005, HCPCS code Z2004 (surgical pathology, gross and microscopic examination of presumptively normal tissue[s] obtained in conjunction with an abortion procedure) is discontinued as a billable code. Instead, providers must use CPT-4 codes 88300 (Level I – surgical pathology, gross examination only) or 88304 (Level III – surgical pathology, gross and microscopic examination), but not for both, for the surgical pathology, gross and microscopic examination of presumptively normal tissue(s) obtained in conjunction with an abortion procedure.

Codes 88300 and 88304 are not to be separately reimbursed if billed by the same provider, for the same recipient, for the same date of service, as abortion procedure codes 59840, 59841, 59850, 59851, 59852, 59855, 59856 or 59857 when billed:

• For a female recipient and
• With an ICD-9 abortion diagnosis code (635 – 635.9, 636 – 636.9, 637 – 637.9, 638 – 638.9) or
• With an unwanted pregnancy code (V61.7 – V61.79)

Note: If the claim documents that the surgical pathology is for a specimen other than that resulting from an abortion procedure, the claim may be separately reimbursed.