Pathology/Lab Coding Alert

Question: Since the TC Grandfather Provision ended July 1, 2012, we're receiving approximately six denials per week from our Medicare contractor for anatomic pathology services for non-hospital patients. For example, a Medicare patient went to a physician's office and had a skin lesion removed. Our pathology lab received the skin specimen, processed it, and reported back to the physician. We billed 88305, but received a denial indicating "not a covered service -- Must bill to part A contractor." Our Medicare representative told us that the patient received another service on the same day as a hospital outpatient (place of service 22). That made our global 88305 claim deny, as though we were charging the technical component (TC) for a hospital outpatient. Is there a modifier we can use, such as 59, to indicate that our service was for a non-hospital patient? Arkansas Subscriber Answer: Unfortunately, no, there is not a modifier [...]