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Wiki Lab Billing

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oreyeszwirn

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When billing 88305 is it required to have a diagnosis code attached?:confused:
 
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?
 
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
 
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.
 
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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