Pathology/Lab Coding Alert

Question: Does the referring physician need to request the PAS/Alcian blue stain before the pathologist can perform the stain to rule out Barrett’s esophagus?New York SubscriberAnswer: When a pathologist receives a specimen for examination and diagnosis, the referring physician does not have to specifically order ancillary tests such as special stains that the pathologist determines are necessary to reach a final diagnosis. According to the Medicare Benefit Policy Manual (IOM 100-02) chapter 15 section 80.6.5, an independent laboratory pathologist may perform additional tests that the referring physician does not specifically order under the following circumstances:These services are medically necessary so that a complete and accurate diagnosis can be reported to the treating physician/practitioner;The results of the tests are communicated to and are used by the treating physician/practitioner in the treatment of the beneficiary; and The pathologist documents in his report why additional testing was done.That said, coding the periodic acid-Schiff [...]