Wiki Addendum signed by different pathologist than initial final report

[atipton12]

I am having trouble finding documentation on how to bill addendums to a pathology report if the addendum is signed by a different pathologist than the pathologist that signed the initial final report.

For example:
Dr. A signed final interpretation and report for an FNA
Dr. B signed addendum documenting the immediate assessment of that FNA. (no change to diagnosis)

Typically we bill the two codes (88172 & 88173) together on the same claim. Do we bill it with Dr. A who signed the final report or Dr. B who signed the addendum?

Another example:
Dr. A signed final report of gastric biopsy
Dr. B signed addendum documenting special stains performed on the gastric biopsy changing the diagnosis.

Again, we typically bill the codes together on the same claim. Do we bill it with Dr. A who signed the final report or Dr. B who signed the addendum changing the diagnosis? Or if the diagnosis was not changed by the special stains in the addendum which Dr. would we bill for?

Thank you in advance.

 

[lcabanig]

If I'm understanding the scenarios correctly, the first example should be a corrected report

Dr. B did the rapid read (88172) but it wasn't documented on the original report, so he then he had to do an addendum (correction) to add the service. In that case, you bill the claim out with the pathologist who provided the interpretation (88173) and the final diagnosis of the FNA, with a statement that the rapid read was left out in error.


In the second example, on a true addendum case, the claim would be billed out with Dr B's name since he is the one actually providing the final diagnosis.

Hope this helps, here are some links also,


http://www.cap.org/apps/docs/pathology_reporting/Reporting_overview.pdf

http://www.archivesofpathology.org/doi/full/10.1043/1543-2165(2008)132%5B1608%3ARGFCLR%5D2.0.CO%3B2

 

[atipton12]

Thank you for your comment! I understand what you explained. I do have one question regarding your comment on the second scenario...

Let's say Dr. B interpreted the special stains and issued an addendum to bill the special stains and changed the diagnosis, but we have already billed the original report (without the stains signed by Dr. A). Do we then submit a corrected claim by adding the special stains and changing the pathologist to Dr. B? Would make sense to me according to your reply.

Thank you for the links as well. I was able to pull up the first one but the second one states the requested article is not currently available on that site. Can you direct me to an article that explains which pathologist should be on the claim?

 

[bbooks]

I could not get your second link to work. Would you please repost it? Thanks for posting those!

 

[lcabanig]

I'm sorry, I'm not sure why the link doesn't work, if you go the site itself; archivesofpathology.org and type "addendum" in the search box, then it's the first article that pops up named: Reporting guidelines for Clinical Laboratory Reports in Surgical Pathology.

 

[nashton]

Hello all, I know its been some time since this question was first posed, but we were talking about it in my office today and I wanted to expand on the question. If a pathologist signs out a breast case and orders the breast panel (er/pr/her2/ki67) but a second physician, from same group/same tax ID, signs out the addendum/signs breast panel report, can we bill the breast panel with the initial physician since there isn't a change in DX just treatment or do we need to bill with the physician who signed the out the addendum?

Also, like atipton12 stated, and I'm not sure was answered: Let's say Dr. B interpreted the special stains and issued an addendum to bill the special stains and changed the diagnosis, but we have already billed the original report (without the stains signed by Dr. A). Do we then submit a corrected claim by adding the special stains and changing the pathologist to Dr. B? Would make sense to me according to your reply.


Thanks in advance for any additional information.