Summary & Overview
CPT 88037: Postmortem Pathologic Examination of One Organ
CPT code 88037 covers pathologic postmortem evaluation of a single organ, including gross and/or microscopic examination. This code captures a focused autopsy-related service used by pathologists and medical examiners to determine organ-specific findings after death. Nationally, accurate reporting of such postmortem pathology services supports mortality documentation, medicolegal investigation, and quality surveillance in hospitals and forensic settings.
Key payers considered in the coverage and payment landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication examines how these payers approach coverage and coding for isolated organ postmortem examinations, typical billing practices, and the contexts in which 88037 is reported.
Readers will find a concise clinical context for when 88037 applies, typical sites of service, common modifiers used in practice (listed separately), and what to expect in payer interactions. The report also outlines benchmark payment considerations and policy factors that affect documentation and claims adjudication for single-organ postmortem pathology services. Data not available in the input where specific payer rates, taxonomies, or ICD-10 pairings would normally appear.
Billing Code Overview
CPT code 88037 describes a postmortem pathological examination in which the provider performs a gross examination, microscopic examination, or both of a single organ of the body after death. The service type is pathologic postmortem examination of one organ. The typical site of service for CPT code 88037 is a hospital pathology or medical examiner facility where tissue specimens from a decedent are processed and evaluated.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves a decedent who undergoes postmortem examination of a single organ to determine cause of death, evaluate disease extent, or document pathologic findings for medicolegal, clinical, or family counseling purposes. For example, a 68-year-old hospitalized patient dies after a prolonged ICU course with multi-organ failure; the clinician requests examination of the heart to evaluate for acute myocardial infarction. The pathology workflow begins with receipt of the organ or organ sample in the pathology suite, gross description (size, weight, external features), targeted sectioning, and submission of representative tissue for histologic processing. The pathologist performs microscopic review and generates a diagnostic report. Specimen accessioning, chain-of-custody and documentation are completed, and ancillary testing (toxicology, microbiology, immunohistochemistry) is ordered if indicated. Billing for the single-organ postmortem examination uses 88037 when gross, microscopic, or both examinations of one organ are performed and reported.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Default reporting when no informational modifier applies. |
22 |