Question Billing for Shave biopsy 11102 and 87207-26 -or- 88305-26 ?

cinike

Contributor
Messages
12
Location
Rye Brook, NY
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0
I have the following situation:

1) My Doctor personally did a shave biopsy on a patient and billed 11102.

2) My Doctor collected the specimen and prepared it for delivery to the lab.

3) The lab sent back a report.

4) My Doctor read the report, evaluated it and discussed it with the patient.

Questions:
A) Can My Doctor bill 87207-26 for reading, evaluating and discussing the report
with the patient in addition to an E/M code (99212)?

B) Should my Doctor bill 88305-26 instead of 87207-26?

C) If 88305-26 is the better code, can 88305-26 be billed and an E/M code (99212)
for the same date of service?

Thanks!
 

danachock

Guru
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214
Location
Brainerd, MN
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Hi cinike,
In my opinion you are not offering enough information to provide advice to you. Provider performed procedure 11102, where does 87207 fit in this? Unsure how to help with an E&M visit or pathology charge when no information is simply provided. Bare minimum (without PHI) information can simply assist you with your coding woes. Information from the OV along with the pathology macro, micro & interpretation. I'm unsure what is being done to support or deny billing your charges.
Thanks for listening,
Dana Chock, RHIT, CPC, CANPC, CHONC, CPMA, CPB
Coding Analyst (May 2018-present), Pathology & Laboratory coder (Fall 2012 - May 2018); Anesthesia Coder (April 2013-May 2018)
 

mitchellde

True Blue
Messages
13,430
Location
Columbia, MO
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1
Your provider is not the pathologist, so collecting the specimen and preparing it for delivery to the pathologist is simply part of the biopsy procedure. reading, evaluating and discussing the report are part of the E&M, so unless your provider is also the pathologist you cannot bill any more than the procedure when performed and if out of the global you may bill the E&M and that is all given the information you supplied.
 
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