LEEP Cervical Biopsy vs. Conization

There are two CPT codes to choose from for a cervical biopsy specimen.  

∗ 88305 - Surgical pathology, gross and microscopic examination, cervix, biopsy

∗ 88307 - Surgical pathology, gross and microscopic examination, cervix, conization

How do you decide?  A review of the op notes may be one way. For example, if the surgeon identifies the LEEP specimen as a biopsy or conization, or if the following surgical procedures are listed for specimens obtained during a colposcopy. 

∗ 57460 - Colposcopy of the cervix including upper/vagina; with loop electrode biopsy(s) of the cervix

∗ 57461 - ………….with loop electrode conization of the cervix

What if there is no documentation distinguishing between cervical biopsy and cervical cone or the specimen label and the physical specimen don’t match?  In this instance, it is left to the pathologist to decide whether each specimen is more like a cervical biopsy or cervical conization.  To support your decision, use keywords such as LEEP biopsy or LEEP cone in the final diagnosis.  It’s not uncommon to receive two or three LEEP specimens in separate containers.  If they are separately examined and diagnosed, report 88307 for each.