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23055 Surgical Pathology, Gross and Micro Exam

Surgical Pathology, Gross and Micro Exam
Test Code: SURG
Synonyms/Keywords
​Gross and micro exam, Tissue Report, Anatomic Pathology Tissue Report, Histology
Useful For
​Level of complexity is determined during gross and microscopic examination.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​Tissue Any clean and unused specimen container​ Clean, sealed biohazard bag​ ​ ​ ​
Collection Processing Instructions
Tissue in 10% Neutral Buffered Formalin which is available from the Histology Department. Adequately label the tissue vial and submit with a completed histology request form containing patient history, requesting physician, collection date, and tissue source. Electronic orders are accepted, but a hard copy must be sent with the specimen.
 
Unlabeled specimens, specimens submitted with an incomplete requisition form or electronic order without hard copy, mismatched tissue and requisition information or specimens for which correct patient identification is questionable are unacceptable.
 
Level of complexity (Level I through VI, as defined by CPT code book) is determined during examination.
Acceptable Specimen Types
​Tissue
Specimen Stability Information
Specimen Type Temperature Time
​Tissue ​Room Temperature/Ambient ​Indefinite
Rejection Criteria
Unlabeled
​Mismatched Tissue and Requisition Information
​Electronic Orders Without Hard Copy Accompanying Specimen
​Incomplete Requisition Form
Specimens for Which Correct Patient Identification is Questionable
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield ​Monday - Friday ​2 days ​
Reference Range Information
Performing Location Reference Range
​Marshfield ​ Interpretive Report
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
88300​ ​ ​ Level I​ ​
88302​ ​ ​ Level II​ ​
88304​ ​ ​ Level III​ ​
88305​ ​ ​ Level IV​ ​
88307​ ​ ​ Level V​ ​
88309​ ​ ​ Level VI​ ​
Synonyms/Keywords
​Gross and micro exam, Tissue Report, Anatomic Pathology Tissue Report, Histology
Ordering Applications
Ordering Application Description
​Centricity ​None
​Cerner ​Pathology Tissue Request
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​Tissue Any clean and unused specimen container​ Clean, sealed biohazard bag​ ​ ​ ​
Collection Processing
Tissue in 10% Neutral Buffered Formalin which is available from the Histology Department. Adequately label the tissue vial and submit with a completed histology request form containing patient history, requesting physician, collection date, and tissue source. Electronic orders are accepted, but a hard copy must be sent with the specimen.
 
Unlabeled specimens, specimens submitted with an incomplete requisition form or electronic order without hard copy, mismatched tissue and requisition information or specimens for which correct patient identification is questionable are unacceptable.
 
Level of complexity (Level I through VI, as defined by CPT code book) is determined during examination.
Acceptable Specimen Types
​Tissue
Specimen Stability Information
Specimen Type Temperature Time
​Tissue ​Room Temperature/Ambient ​Indefinite
Rejection Criteria
Unlabeled
​Mismatched Tissue and Requisition Information
​Electronic Orders Without Hard Copy Accompanying Specimen
​Incomplete Requisition Form
Specimens for Which Correct Patient Identification is Questionable
Useful For
​Level of complexity is determined during gross and microscopic examination.
Reference Range Information
Performing Location Reference Range
​Marshfield ​ Interpretive Report
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield ​Monday - Friday ​2 days ​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
88300​ ​ ​ Level I​ ​
88302​ ​ ​ Level II​ ​
88304​ ​ ​ Level III​ ​
88305​ ​ ​ Level IV​ ​
88307​ ​ ​ Level V​ ​
88309​ ​ ​ Level VI​ ​
For most current information refer to the Marshfield Laboratory online reference manual.