What this is, in plain language
A pathologist's examination of a tissue sample (such as a skin biopsy, polyp, or breast core biopsy) under the microscope to make a diagnosis.
Why a clinician orders it
Any time tissue is removed during a biopsy, colonoscopy, surgery, or skin procedure.
Medical necessity — what insurers usually look at
Generally covered when linked to a covered procedure. Pathology bills frequently come from a separate lab and may apply to a separate in-network status.
Documentation to ask about
- ✓Source procedure and specimen
- ✓Pathology lab and network status
Questions for your provider
- ?Which pathology lab will read this sample, and is it in my network?
- ?Will I receive a separate pathology bill?
Why this code is in our seed set
#4 on the CMS Top 100 Lab Procedures Ranked by Services (~18 million allowed services); the most-billed surgical pathology code.
Validated against
- •CMS Top 100 Lab Procedures Ranked by Services
- •AMA CPT code 88305 descriptor
- •CAP (College of American Pathologists) coding guidance
Important: AuraCode is an educational tool. It does not provide medical, legal, or insurance advice, claims decisions, or approval guarantees. Final coverage depends on your specific plan, eligibility, diagnosis, submitted documentation, and your insurer's review.