Wiki Oral "brush test"???

[Lisa Bledsoe]

One of my docs wants to start doing this test. It is an oral brushing of a lesion that is sent out for interpretation. The manufacturer is telling him that he can code 40490, 40808, 41100, 41105, 41108 or 41825 depending on the location of the lesion. Now, all of these codes either state "excision" or "incision"...so my question is how can these codes be reported for the brushing? Seems to me it would be a lot like a pap. We have to purchase the special kit for collection and conveyance to the lab (which is also the manufacturer). It seems to me that only 99000 would be reportable for the physician, but we all know that is hard to get reimbursement for. Any comments or suggestions? Is anyone else out there doing this?

 

[tfog]

Hi Lisa, I'm only a student now with regards to the CPC, however, I have worked in two oral & maxillofacial surgeons offices for almost 12 years. The code you're looking for will be in the HCPCS Level II book. Look at code D7288 which is Brush Biopsy--transepithelial sampe collection. The only CPT codes that come close are the miscellaneous codes 40899, 41599, and 41899. Hope this helps!
Beth

 

[Lisa Bledsoe]

Thanks tfog. We have convinced the doc not to do this test and leave it to the dental profession as we do not believe insurance will pay a medical claim for D7288.