danachock
Expert
Hi fellow pathology coders, I received a request on Messenger earlier today for coding assistance. The folks reviewing the coding did not agree with this coder's CPT assignment and simply asked my opinion.
I am not mentioning any names but sharing the information. As a pathology coder being questioned by anyone or even audited is a two-way street. Either you get 100% because they (auditor) didn't know any better and thought it was better to just simply state that you were doing a fine job OR just simply scrutinizing the heck out of it stating you coded something absolutely wrong, when in actuality, you really didn't. Personally, I have been there and done that and will challenge any audit.
First Example - FNA samples all received labeled with Specimen A submitted in formalin and several cell blocks were performed. This is only billed with one cell block. Reference: CPT Assistant July 2005 states it is once per specimen
Second Example - analysis for Kappa and Lambda for In Situ Hybridization analysis is not charged one charge for a specimen; EACH ONE IS SEPARATE AND IS EACH BILLABLE with 88365 with 88364.
I am again so grateful our coding colleague thought that the questions they received were inaccurate and reached out to me and I provided from pathology resources that yes, they were.
I will be an advocate for any pathology coder.
I hope all have a wonderful evening and reach out if you need anything okay.
Dana
I am not mentioning any names but sharing the information. As a pathology coder being questioned by anyone or even audited is a two-way street. Either you get 100% because they (auditor) didn't know any better and thought it was better to just simply state that you were doing a fine job OR just simply scrutinizing the heck out of it stating you coded something absolutely wrong, when in actuality, you really didn't. Personally, I have been there and done that and will challenge any audit.
First Example - FNA samples all received labeled with Specimen A submitted in formalin and several cell blocks were performed. This is only billed with one cell block. Reference: CPT Assistant July 2005 states it is once per specimen
Second Example - analysis for Kappa and Lambda for In Situ Hybridization analysis is not charged one charge for a specimen; EACH ONE IS SEPARATE AND IS EACH BILLABLE with 88365 with 88364.
I am again so grateful our coding colleague thought that the questions they received were inaccurate and reached out to me and I provided from pathology resources that yes, they were.
I will be an advocate for any pathology coder.
I hope all have a wonderful evening and reach out if you need anything okay.
Dana