88305 and 88112 Together?

dballard2004

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Can one bill 88305 + 88112 on the same case?


I was always told one cannot bill ThinPrep and Cell Block on the same case. Someone told me today that this is true for FNAs but not fluids. Does the AMA say anything about this?
 

danachock

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dballard2004,​

Thin preps (88112) are typically what I see when a thin prep (88112) and cell block (88305) are performed together at one of the facilities that I review their pathology coding. I'm just curious today why someone would state that 88112 would not be billable with a cell block and would like to hear the explanation please if possible? Thinking about this further, I actually, have one of the facilities I work for that utilizes a unique accessioning system and based on the set up of their system that they actually utilize two accessions - one for the thin prep and another accession for the cell block.
Again, I don't see any issue billing a "rapid" FNA evaluation (88172) or the professional interpretation of the FNA (88173) with a cell block. The rapid evaluation is either deeming it adequate or not. The professional interpretation is the "typically the slides" received but could be from other preparations. The cellblock is the from my review "usually" the means for applying IHC (immunohistochemical stains) or multiple IHC's when malignancy or possible malignancy is "probable" to rule in or rule out a diagnosis.
Thank you for listening and have a wonderful evening,
Dana

I am editing my statement to share additional information only for my pathology colleagues please - I have not changed the previous AAPC post but am just simply sharing additional details. I work in a pathology position that reviews many different pathology facilities coding work processes of their coding scenarios. So please do not be alarmed why I would ask why a facility I am not reviewing their coding scenarios simply may code something a certain way that may be alright or not (I have seen both scenarios). My goal is to simply understand the fundamentals on the "why" please! If you review other AAPC posts of mine (there are plenty) I will assure you that my intentions and questions are sincere. In my former pathology roles, I have not had to code radiology specimens before, or the FNA actually performed by a pathologist either. I clearly have learned from my AAPC colleagues and my own research and have been able to catch up on those areas of coding moving forward and provide feedback in those pathology coding areas.
I did want to add that reviewing pathology cases today that when a TP (thin prep) or FNA was performed that the pathology reports sometimes states "a cell block was examined for diagnosis". Or "immunohistochemical stains applied to the cell block confirmed this or ruled out this". Reviewing our CPT book again this evening the "Cell Block" is separately listed in our CPT book under 88305 that "Cell block, any source" may be billed. I did check the edits and there are none when billing with 88112 or 88173.
My wholehearted purpose is to help my pathology colleagues, share and learn from our experiences together as a pathology team, and be an advocate that I would like to be in the pathology world. I clearly don't have all the answers but am eager to learn with my colleagues help.
Again, thank you for listening have a wonderful evening,
Dana Chock CPC, CANPC, CHONC, CPMA, CPB, RHIT
 
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