Wiki 88348 technical charge.

[Amanda-D]

I have a provider that believes that they should be able to bill for technical charge for work being done on Electron microscopy. But in our pathology manual it states. It's never proper to report two codes for a complete microscopy study; that is, don't post 88348 for the ultra-thin section examination and another for the thick section review. Also, don't report technical or professional code for any type for "embed and hold" specimens; if processing is ordered and thick or ultra-thin sections are examined, the "embed and hold" step is part of the diagnostic procedure, but otherwise it's not chargeable as patient care event. Are they able to get any credit for the processing?

 

[danachock]

Hi Amanda1970
I'm a little lost on your post. I am acclimated on coding both "Thick and also EM.
If its "thick" only and it is only the "thick reviewed" it is a solid 88305 charge.
If it is EM (electron microscopy) then we do not bill for the thick; and bill 88348 is billed instead (the thick is inclusive in the charge for 88348).
I am unsure on your embedded and hold stuff. You haven't shared what was actually was done., I need a pathology report please.
I get the 88313x3, 88346, 88348, 88350x8 with 88305x1 unless transplant then 88350x9.
Your pathologist seems to possibly have some coding experience? There isn't a lot here. I would SIMPLY STOP AND LISTEN TO YOUR PATHOLOGIST at this point. I have forever been grateful for any advice my pathology team has ever provided.
Stop, lets reassess the situation, circle the wagons and return in a few days alright.
Thank you for listening,
Dana

 

[Amanda-D]

Hi Dana,

Thank you for your information. Sorry. I did not mention the EM are being deferred for possible later review which they are not rendering a final diagnosis for patient care. The pathologist is wanting to get a 88348 technical charge for the work that is required for the embedding and hold steps. Pathology manual states if processing is ordered and thick or ultra-thin sections are examined, the "embed and hold" step is part of the diagnostic procedure, but otherwise it's not chargeable as patient care event. I don't believe we are able to bill anything until the EM dx is rendered for the procedure.

Thanks

 

[danachock]

Hi Amanda-D,
Oh goodness, now I believe that understand what is happening. A renal biopsy was performed and the work to perform the EM has been performed so the pathologist wants to bill the technical but a final diagnosis from that EM has not been rendered yet because in the end that procedure may ultimately be "deferred" (that is what I see stated in the pathology report) when they may have prepared for it but decided not to do it.
No, we wouldn't bill either the professional or technical charge for 88348 or even the "thick" until the pathologist's interpretation has been provided. It is common to see the charges populate for this scenario when final diagnosis is rendered (without the EM) and for whatever reason it was decided to perform the EM at a later date (a few weeks later) and then the addendum is issued that populates the 88348 (professional & technical charges) to complete the coding.
Thank you for the explanation.
Have a wonderful evening,
Dana

 

[Amanda-D]

Hi Amanda-D,
Oh goodness, now I believe that understand what is happening. A renal biopsy was performed and the work to perform the EM has been performed so the pathologist wants to bill the technical but a final diagnosis from that EM has not been rendered yet because in the end that procedure may ultimately be "deferred" (that is what I see stated in the pathology report) when they may have prepared for it but decided not to do it.
No, we wouldn't bill either the professional or technical charge for 88348 or even the "thick" until the pathologist's interpretation has been provided. It is common to see the charges populate for this scenario when final diagnosis is rendered (without the EM) and for whatever reason it was decided to perform the EM at a later date (a few weeks later) and then the addendum is issued that populates the 88348 (professional & technical charges) to complete the coding.
Thank you for the explanation.
Have a wonderful evening,
Dana

Hi Dana,

Thanks for responding back.