Part B Insider (Multispecialty) Coding Alert
Rereads May Not Warrant Recharges
PDF
Question: When one pathologist in our practice asks another pathologist in our practice to “reread” pathology slides that have already been read and billed, can we bill for this additional service as a second opinion?
Answer: No, you should not bill for pathology slide “rereads” within your practice. This isn’t a “second opinion” or “consultation” because the two pathologists are in the same practice. You can’t have a consultation with yourself.
Instead, having a pathologist within the group look at slides to confirm/comment on a diagnosis is considered quality assurance and the cost of doing business. That’s true whether the second pathologist in the practice looks at the slides during the initial case, or pulls the slides from archives to look at them later.
Part B Insider (Multispecialty) Coding Alert
- Pulmonary Coding:
Collect for Your Pulmonary Education Services With These 5 Tips
Inhaler demo could pay you $19 — if you know how to navigate the rules. [...] - ICD-10:
J45 Shifts Focus to Severity for Asthma Reporting
Hint: Identify symptoms and medication use for accurate reporting. Asthma is a common condition that [...] - Medicare Drug Screens:
G0431, G0434 Define Your Options
Steer clear of the 80100 series for this payer. If you’re reporting drug screening tests [...] - Reader Question:
Rereads May Not Warrant Recharges
Question: When one pathologist in our practice asks another pathologist in our practice to “reread” [...] - Reader Question:
Check Records to Nail Down Laryngoscopy Code
Question: Our physician recently performed a laryngoscopy during which he removed a foreign body. As [...] - Reader Question:
Get to Know Modifiers ZA and ZC
Question: Do you have any information on the correct use of modifiers ZA and ZC? [...] - Reader Question:
Arteriography Offers Several Options
Question: My doctor performed LHC, aortic root arteriography with runoff, and a bilateral renal arteriogram. [...] - Reader Question:
Know the Rules for Add-ons
Question: Our physician recently performed the infusion of two anti-neoplastic substances for a patient. I [...] - Physician Notes:
CMS Sets Jan. 6 as Ordering/Referring Edit Implementation Date
If your practice put phase two of the Medicare ordering and referring edits on the [...]