CPT® Code 88037

1. Indications

The indications for performing a limited necropsy (autopsy) on a single organ include the following:

• Medical Cause of Death The primary indication is to determine the medical cause of death when it is unclear or requires further investigation.
• Pathological Insight To gain insights into the pathological processes of a disease that may have contributed to the death.
• Outcome Evaluation To evaluate the outcomes of treatments that were administered prior to death, particularly in cases where the effectiveness of the treatment is in question.
• Family Considerations When there are personal or religious circumstances expressed by the family that necessitate a limited examination rather than a full autopsy.

2. Procedure

The procedure for conducting a limited necropsy on a single organ involves several detailed steps:

• External Examination The process begins with a thorough external examination of the body. This includes documenting any visible wounds, cleaning the body, and taking measurements and weight. A general description of the body is recorded, noting characteristics such as gender, approximate age, ethnicity, hair color and length, eye color, and distinguishing features like tattoos or scars.
• Incision Techniques To access the internal organs, various incision techniques may be employed. For the chest organs, a “Y” incision, a “T” incision, or a midline vertical incision is made. This allows for the ribs and sternum to be lifted as a single unit to expose the chest cavity.
• Heart and Circulatory System Examination The pericardial sac is opened to view the heart, and blood samples may be taken from major vessels such as the inferior vena cava or pulmonary veins. The pulmonary artery is examined for blood clots, and the heart is removed after transecting the major vessels.
• Pulmonary System Examination The left lung is removed by transecting the bronchus, artery, and vein at the hilum, followed by the removal of the right lung.
• Abdominal Organ Examination A midline incision is made from the xiphoid process to the pubic bone to examine the abdominal organs. These organs are assessed in relation to blood vessels before being removed individually or as a block.
• Brain Examination If the examination is limited to the brain, an incision is made across the crown of the head from ear to ear. The skull is exposed, and a bone flap is created to access the brain, which is then removed for further examination.
• Microscopic Review Preparation If a microscopic review is ordered, fluid and tissue specimens are processed onto slides for analysis, which may include testing for pathogens, drugs, or genetic diseases.
• Closure of Incisions After the examination, the body cavity is lined with appropriate material, the internal organs are sealed in a plastic bag and returned to the body, the skull flap is replaced, and all incisions are re-approximated and closed.

3. Post-Procedure

Post-procedure care following a limited necropsy involves ensuring that the body is treated with respect and dignity. The body is prepared for any necessary viewing or burial arrangements as per the family's wishes. The internal organs that were examined are sealed in a plastic bag and returned to the body, and all incisions are carefully closed to maintain the integrity of the body. It is important to document the findings of the necropsy thoroughly, as this information may be valuable for medical records, research, or legal purposes. Additionally, if microscopic examinations were performed, the results should be communicated to the appropriate parties as part of the overall findings of the necropsy.