Wiki FLOW PROFEESIONAL 88187-88189

Create Wiki Sort by votes
P

pribbing

New
Messages
6
Best answers
0
Questoin: If an Independent Pathology Lab, performs 2 different FLOW profiles (24 mrakers) on one and different18(markers) on the other profile, on the same specimen and same DOS and there are different result for each profile, are you allowed to bill MCR 88189 x 2 for each profile or just 88189 x 1?
 
0
Hi pribbing,
There are a few variables here. Would you please be able to explain what you mean by the "same specimen" and I may be able to help. When I state that - is it one specimen was acquired and split between two flow cytometry sessions? Or from one surgical procedure a specimen was acquired labeled AAAAA from one part of the body and another specimen labeled BBBBB from another part of the body was each sent for flow cytometry analysis or possibly another scenario not mentioned??
Thanks,
Dana Chock, CPC, CANPC, CHONC, CPMA, CPB, RHIT
 
0
Hi pribbing,
I have a lot of information to share on this.
First when a flow cytometry is performed - it isn't like the patient (or pathologist's) gets to state that "I only want 6 panels performed".
I am going to share exactly what my pathologist's (go to person for many years, presented for our chapter many years stated at our "May Mania" shortly after I started and I'll never forget their presentation on flow cytometry).
You have a classroom of Johnny's - they all look exactly the same looking at them in the classroom, they are xxxxx hair, xxxxx eyed, wearing the exact same blue shirt and matching cap. But Flow Cytometry can identify those differences with antibodies (other health care facilities may refer to them as markers, or panels). A patient or pathology provider cannot just simply order a flow cytometry to be performed asking for a set number of panels, antibodies, markers to simply be performed. The testing is completed when all the Johnny's have been identified from one against the other.
My question is how do you have one specimen (divided into two portions) and placed into two separate flow cytometry profiles? And why? Isn't that redundant? Possibly a waste of resources and possibly a pathologist's time? My next question is why does one have more markers then the other? Are you sure on specimen source?
Next question, we have one flow profile with 24 markers and another with 18 markers for the same specimen. How do you justify billing both sets if it was the same specimen? If it was the same specimen just review both reports and validate the number of markers/panels/antibodies and just bill appropriately those that do not overlap each other and hope it is the same provider or they get "paper, rock, scissor for their reimbursement".
I am clearly baffled on this difference, but I have seen some craziness in my career.
I am hopeful I have provided some help for this coding issue.
Dana Chock, CPC, CANPC, CHONC, CPMA, CPB, RHIT
 
0
I have a question on this. We usually do flow citometry (88189) with 25 markers on peripheral blood. Then same physician and on same DOS does a PNH interpretation (88187) which uses 8 markers. Are we to bill two cases separately and attach an XS or XE modifier on the second case 88187, 88184, and 88185x7? or can we combine the technical components for both? And bill 88184x2 and 88185x31? I guess my main question is since we have two reports, are we to bill separately all components?
 
0
Hello raphaguz@yahoo.com,
There were two distinct billing scenarios. I would ABSOLUTELY NEVER COMBINE TWO BILLING SCENARIOS TO DRIVE CPT CHARGES (either professional or technical). The Flow Cytometry 88189 was performed. Same day the PNH interpretation was performed. You need to apply the appropriate modifiers to bill 88187 with 88189 for same day of service. Please learn how to help appeal these coding scenarios. I am hopeful that where you work that they throw stuff at you to assist with fighting denials. If this is on your billing/coding "denial team" and they are sending you this stuff. Maybe have some conversations to assist capturing RVUs.
 
You must log in or register to reply here.
Top