Pathology/Lab Coding Alert

Question: We have a confusing billing situation in which one pathologist is covering frozen sections for another. One pathologist is the verifier on the complete final report, but the other is the verifier beneath the frozen section diagnosis portion of the report. Can the pathologist of record for the final report bill for all services, including the frozen sections, even though a different pathologist is verifier for that section?

Surya Narayanan, MD
Sayre, Pa.

Answer: When one pathologist performs a frozen section, then he/she will bill code 88331 (pathology consultation during surgery; with frozen section(s) single specimen). If the second pathologist performs the gross and microscopic examination of the tissue, use codes 88302-88309 (levels II, III, IV, V or VI; surgical pathology, gross and microscopic examination).

If the pathologists have a contract in which one pathologist is paid under a reciprocal billing arrangement, then the procedure performed by the substitute physician would be billed with modifier -Q5 to describe that a substitute physician furnishes the service under a reciprocal billing arrangement.