Did You Know Frozen Sections Break the Rules?
Published on Sat Oct 18, 2003
You keep reminding yourself that you can't code per block. And you're right - for cytopathology and surgical pathology with certain ancillary services. But you're not right if you're talking about frozen sections.
In fact, you do code frozen sections per block. To complicate matters, you even code the blocks differently depending on whether they are from the same or different specimens. 'Frozen Section' Means Consultation During Surgery The frozen section codes are part of the code family beginning with CPT 88329 (Pathology consultation during surgery). Report this code when the surgeon asks the pathologist to consult on a patient during surgery, but the pathologist performs a gross-only consultation rather than examining frozen tissue sections.
The frozen section codes are part of the same family:
88331 - ... first tissue block, with frozen section(s), single specimen
88332 - ... each additional tissue block with frozensection(s).
The codes describe not just the frozen section preparation but also the pathologist's interpreting and reporting results to the surgeon during surgery.
Do not report these codes when the lab prepares frozen tissue blocks and sections as part of a different procedure that does not involve a consultation during surgery, such as 88314 (Special stains [list separately in addition to code for surgical pathology examination]; histochemical staining with frozen section[s]). Code 88314 includes the frozen section preparation and interpretation for studies such as muscle tissue ATPase and NADH staining for the diagnosis of muscle atrophy or dystrophy, says Elizabeth Sheppard, HT (ASCP), manager of anatomic pathology at Wake Forest University Baptist Medical Center in Winston Salem, N.C.
"Because 88329-88331 are part of the same code family, sharing the same definition preceding the semicolon, you should not report either 88331 or 88332 with the parent code (88329) for the same specimen," says Laurie Castillo, MA, CPC, CPC-H, CCS-P, president of Professional Coding and Compliance Consulting in Manassas, Va. If the pathologist prepares and interprets frozen sections during surgery, the code (such as 88331) includes the consultation service described by 88329. The National Correct Coding Initiative edits confirm this bundling. "Only if the pathologist performs a gross consult on one specimen and a frozen section consult on a different specimen should you report 88329 with the frozen section codes. Then you'd have to use modifier -59 (Distinct procedural service) to override the edit," Castillo says. Code per Block, but Beware the Specimen If the pathologist interprets frozen sections from multiple blocks prepared from the same specimen, you should report both codes 88331 and 88332. Use 88331 to report the first block from a given specimen. Regardless of the number of sections, you should report 88331 when the pathologist examines sections from only one block.
If the pathologist prepares and interprets frozen sections from [...]
