Pathology/Lab Coding Alert

You'll still need physician for professional component. You can't report 88367-88368 (Morphometric analysis, in situ hybridization (quantitative or semiquantitative), each probe) if a PhD results the test instead of a physician interpretation. Should you expect the same restriction if you're using the new codes for urinary tract specimens (88120-88121, Cytopathology, in situ hybridization (e.g., FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen)? "Medicare law doesn't recognize doctorate level professionals (PhD) for professional component payment," says Dennis Padget, MBA, CPA, FHFMA, president of DLPadget Enterprises Inc. and publisher of the Pathology Service Coding Handbook, in The Villages, Fla. "Medicare law isn't affected by state certification standards for PhDs -- test results by a laboratory PhD alone aren't payable under Medicare Part B...period." Review CMS 88367-88368 Restriction Don't expect to report 88367 or 88368 to Medicare if a PhD alone performs the professional component. CMS states the following in [...]