Bone marrow reports pathology

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El Paso, TX
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PLEASE ADVISE ON HOW TO BILL BONE MARROW REPORTS FOR PATHOLOGY.

Can all of these CPT codes be billed if stated on the report?

[*]85097 - Bone marrow; smear interpretation only, with or without
[*]differential cell count
[*]85060 - Blood smear, peripheral, interpretation by physician with
[*]written report
[*]88305 - Surgical pathology; gross and microscopic
[*]88311 - Decalcification
[*]88189 - Flow Cytometry
[*]88313/88312/88342/88341- Special/Immuno Stains



Graciela Lopez-Villa, NCICS, CPB
Coding & Reimbursement Specialist | Department of Pathology
 

danachock

Guru
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Brainerd, MN
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Hi Graciela,
Yes, all of these charges may be billed on the same claim. Procedure 88342 would need an appropriate modifier to be billed with procedure 88189. With that being said procedure 88189 is a flow cytometry interpretation of 16 or more markers. There was no mention of the markers (AKA as panels) being billed; how are the charges for procedure 88184 and procedure 88185 being billed? Also I have to ask - you have 88305 listed but what is that charge exactly being billed for? It is typical for both a "clot" biopsy and "core" biopsy to be performed for the facility I work for and we would bill each appropriately with procedure 88305 and the subsequent charge would have the appropriate modifier. When you are billing out procedure 85060 & 85097 they are interpretation (professional only) fees and you would not apply modifier 26. Just to save any headaches with possible claim rejections or denials.
Thanks for listening & have a great evening,
Dana Chock, RHIT, CPC, CANPC, CHONC, CPMA, CPB
Coding Associate Analyst (former pathology coder 2012-2018)
 
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El Paso, TX
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Hello Ms. Dana, Thank you so much for your response. I really appreciate it.

I just bill for the professional components.

Are there any more CPT codes that can be bill for a BM report?
If we are wanting to bill for a peripheral blood smear or a bone marrow, smear interpretation review by a pathologist: does it have to been itemized (A, B, C, etc) or can it just be mentioned in the report.

Thank you!!

Graciela Lopez-Villa, NCICS, CPB Coding & Reimbursement Specialist | Department of Pathology
 
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Dana Chock, RHIT, CPC, CANPC, CHONC, CPMA, CPB
Coding Associate Analyst (former pathology coder 2012-2018)

Hi Dana! This might be a few dumb questions. Where can I get more information on Pathology coding? Is there such a thing as becoming a certified pathology coder? Obviously from your signature I feel there is but I’m not seeing it listed as a specialty option on AAPC.
Thank you
Tabitha, CPC
 
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