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Bone marrow smear interpretation

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afisher187

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8
Location
Wauseon, OH
Could I get some advice please? I have an oncologist who wants to bill 99245, with CPT 38221 for bone biopsy and also the 85097 for smear intrepretation. He does look at the sample and prepairs a brief report on the smear which is included in the documentation for that visit. The sample is also forwarded to pathology.

Is is proper to code the 85097 with 38221?
 
I could be wrong but i would say that he can't bill 85097 since he is sending the smear to a pathologist. My doctor only bills the 38221 and the pathologist either in our hospital or an outside lab bills the rest. Is he documenting a complete interpt like a pathologist would ??
 
There is a brief report included in the body of the encounter note, but the sample collected is sent to pathology for complete work up as well. There is a complete report from the pathologist then.

My feeling is it should not be billed but the doctor is insisting that it should.

Any opinion would be appreciated! Thank you.
 
I agree. I do not think it should be billed since it is being sent to a pathologist. I bill 38221 + G0364 for our bone marrow asp/bx that we do in the office.

Len Hales, RN, CPC
 
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