Nail Testing for Fungus (Onychomycosis)


Nail Testing for Fungus (Onychomycosis)


To be assigned by Pathology

  • 88300 – Level I;  Surgical pathology, gross examination only
  • 88302 – Level II; Surgical pathology, gross and microscopic examination
  • 88304 – Level III; Surgical pathology, gross and microscopic examination
  • 88305 – Level IV; Surgical pathology, gross and microscopic examination
  • 88307 – Level V; Surgical pathology, gross and microscopic examination
  • 88309 – Level VI Surgical pathology, gross and microscopic examination
  • 88312 – Special Stains
  • 88313 – Special Stains


<Onychomycosis> traditionally referred to a nondermatophytic infection of the nail but is now used as a general term to denote any fungal nail infection (tinea unguium specifically describes a dermatophytic invasion of the nail plate).  In spite of the clearly diseased appearance associated with this condition, onychomycosis is all too often regarded as merely a cosmetic problem of relatively minor importance that is hardly worth the effort to resolve.  This belief may have been supported by the adverse effects and long dosing courses associated with some of the earlier antifungal agents.

<Onychomycosis> in immunocompromised patients, such as those infected with human immunodeficiency virus (HIV), can pose a more serious health problem.  Not only does the difficult-to-treat infection serve as a constant reminder to the patient of his or her own deteriorated condition, but the possibility exists of transfer of a very high titer of fungal pathogens to another person.7


Gross and microscopic examination with hematoxylin and eosin (H&E) stain.  Special stains (PAS) and special studies (IHC, ISH, etc.) if needed.


Complete a <Dermatopathology Requisition>.

The following information must be completed on each requisition.

  1. Patient’s Name
  2. Patient’s Date of Birth
  3. Social Security Number (if available)
  4. Date and time of collection
  5. Specimen source and tissue type
  6. Requesting Physician name and contact phone number
  7. Thorough clinical history if available
  8. All insurance information must be included to ensure proper billing.


Report interpreted by a qualified pathologist in conjunction with histological examination, relevant clinical information, and applicable controls.

Interpretive Data:

Interpreted as <POSITIVE> or <NEGATIVE>


Place nail fragments in an empty sterile container.


  • Frozen specimens
  • Refrigerated
  • Specimens in formalin substitute (alcohol-based)