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Pathology/Lab Coding Alert

Reader Question:

88220 Won't Stand Alone

Published on Fri Oct 15, 2010

Question: We didn't receive payment for an 88280 charge because we did not bill it with a "base procedure," according to the denial. Can you explain the rejection? How could we avoid future denials? Maryland Subscriber Answer: Your original bill either missed the base  chromosome analysis procedure, or incorrectly listed the base procedure as 88280 (Chromosome analysis; additional karyotypes, each study) instead of the more specific code from 88261-88269. Although CPT does not list 88280 with a "+" to designate that it is an add-on code, it functions as an add-on. Cytogenetic codes 88230-88299 are "building block" codes. You should select the appropriate codes in the range that describe each step that your lab performs for a complete cytogentic study. For instance, you might report: • 88237 (Tissue culture for neoplastic disorders; bone marrow, blood cells) for the tissue culture step • 88261 (Chromosome analysis; count 5 cells, 1 karyotype, [...]
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