jdavenport02
Networker
I need some help please. I am not familiar with CPT codes 80500 or 80502 enough to help a pathologist determine if these codes can be billed with the documentation he has provided on the report.
Here are his questions:
1-Does the request for a comprehensive BM consultation on the routine accession sheet constitute a request for a consultation as applied to these codes?
2-Does a summary report satisfy the requirement of these codes?
3-What constitutes a comprehensive “review of patient's history and medical record” to differentiate 80500 from 80502?
Here is the report:
Summary Discussion:
Plasma cell myeloma is not identified. Overall the findings support the clinical impression of monoclonal gammopathy of undetermined significance (MGUS). Because of the hypercellularity and megakaryocytic hyperplasia a myeloid stem cell disorder (myelodysplasia or a myeloproliferative neoplasm) cannot be completely ruled out but the criteria are not met on this study.
Bone Marrow Morphology:
The bone marrow biopsy is approximately 70% cellular. Megakaryocytes are present in slightly increased numbers. Plasma cells are moderately increased. Light chain restriction is not identified on a dual Kappa/Lambda immunostain. An iron stain of the biopsy specimen shows decreased iron stores.
Flow Cytometry:
Flow cytometric analysis of the hemodilute sample demonstrates mild plasmacytosis with a normal Kappa:Lambda but absent CD19 expression.
Immunohistochemistry:
Plasmacytosis (approximately 5-10%), polyclonal. Mild megakarycytic hyperplasia.
Cytogenetics Analysis:
Karyotype: 46,XX[20]
Interpretation: Normal female chromosome complement observed in the 2 GTW banded cells analyzed. There was no evidence of a chromosome abnormality within the limits of the technology utilized.
ANY and ALL feedback is greatly appreciated!
Thanks!
Here are his questions:
1-Does the request for a comprehensive BM consultation on the routine accession sheet constitute a request for a consultation as applied to these codes?
2-Does a summary report satisfy the requirement of these codes?
3-What constitutes a comprehensive “review of patient's history and medical record” to differentiate 80500 from 80502?
Here is the report:
Summary Discussion:
Plasma cell myeloma is not identified. Overall the findings support the clinical impression of monoclonal gammopathy of undetermined significance (MGUS). Because of the hypercellularity and megakaryocytic hyperplasia a myeloid stem cell disorder (myelodysplasia or a myeloproliferative neoplasm) cannot be completely ruled out but the criteria are not met on this study.
Bone Marrow Morphology:
The bone marrow biopsy is approximately 70% cellular. Megakaryocytes are present in slightly increased numbers. Plasma cells are moderately increased. Light chain restriction is not identified on a dual Kappa/Lambda immunostain. An iron stain of the biopsy specimen shows decreased iron stores.
Flow Cytometry:
Flow cytometric analysis of the hemodilute sample demonstrates mild plasmacytosis with a normal Kappa:Lambda but absent CD19 expression.
Immunohistochemistry:
Plasmacytosis (approximately 5-10%), polyclonal. Mild megakarycytic hyperplasia.
Cytogenetics Analysis:
Karyotype: 46,XX[20]
Interpretation: Normal female chromosome complement observed in the 2 GTW banded cells analyzed. There was no evidence of a chromosome abnormality within the limits of the technology utilized.
ANY and ALL feedback is greatly appreciated!
Thanks!