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Pathology/Lab Coding Alert

Reader Questions:

Check 72-Hour Rule Relevance

Published on Sun Jan 09, 2011

Question: Our pathologist examined a lip biopsy specimen from outpatient surgery performed Dec. 17, but the hospital admitted the patient on Dec. 19. The hospital has referred to the "72- hour rule" stating that the outpatient services become part of a single inpatient claim. What is the date of service for the pathology exam?Answer: The correct date of service for your pathologist's lip biopsy exam (88305, Level IV - Surgical pathology, gross and microscopic examination, lip, biopsy/wedge resection) is Dec. 17. Many payers follow Medicare's date of service (DOS) rule for clinical lab tests and the technical component (TC) of anatomic pathology procedures. The rule states that the date of service is the date of specimen collection, with the following exceptions:For multiple-day collections, use the last dateFor archived specimens (stored over 30 days), use the date the specimen is pulled from storageFor specimens that have been "stored" at least 14 [...]
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