Pathology/Lab Coding Alert

Don't bank on accepted 88321-88323 unit of service. Your pathologist consults with an outside lab on slides taken from a 2006 lumpectomy and a 2009 lymph node fine needle aspiration (FNA). That's 88321 x 2 -- right? Maybe. Your payer determines the answer to that question. The problem: "Although the American Medical Association (AMA) says the unit of service for pathology consultation codes 88321-88325 is 'each case,' CMS begs to differ," says Dennis Padget, MBA, CPA, FHFMA, president of DLPadget Enterprises Inc., publisher of the Pathology Service Coding Handbook, in The Villages, Fla. Distinguish CPT Rules CPT provides three codes for pathology consultations on material referred from an outside institution: • 88321 -- Consultation and report on referred slides prepared elsewhere • 88323 -- Consultation and report on referred material requiring preparation of slides • 88325 -- Consultation, comprehensive, with review of records and specimens, with report on referred material. The unit of service [...]