Wiki Need help Pathology codes

[tholcomb]

Hello All,

I have a question regarding pathology codes 88321, 88342, and 88313 United Insurance is denying the claim due to 88313 not paid separate from 88321 my first thought was to add modifier 59 to 88313 any sugestions.


Thank you,
TH

 

[calexander1265]

The 88321 is for a consultation and report on referred slides prepared elsewhere. The CCI edits hit on both the 88313 and 88342, it would not make sense to bill these with this code. You would need to see in the dictation where the pathologist is performing the stain and the immuno. The dictation should show whether the application of the -59 modifier is appropriate.

 

[tholcomb]

Thank you Cheryl.