Lab Billing

kevbshields

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Louisville, KY
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Yes. It is a surgical pathology code--meaning something definitive is required.

Not to sound stupid, but don't all labs require an ICD for medical necessity?
 

oreyeszwirn

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Charlotte
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Thanks for the reponse. We think this is obvisous too, but we are dealing with a provider that feels that an ICD 9 is not required when billing an 88305 technical component only. Can you refer me to where this maybe documented? Thanks
 

tomtom2

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Section 1842(p)(1)of the Social Security Act requires physicians to report the ICD-9 diagnosis code(s) that explains or justifies the medical necessity of the service or procedure being billed to the Medicare Part B carrier.
 

daizyluvr

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Everett, WA
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Icd-9

Are you billing the insurance company or the provider's office/hospital that did the biopsy? If you are billing the insurance company, it is required to have an ICD-9 code. If you are billing the provider, then it is not necessary.
 
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