pathologist reading

pshaw08

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I have 2 pathologist one, that is preparing the slide to be read and one that actually reads and dictates the results. Im pretty sure the one that reads and dictates bills the codes, but is it out there anywhere on cms as a guideline?

Patricia shaw,cpc
 

danachock

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Pathology reading (interpretation)

Hi pshaw08;
Yes, I completely understand your point working from a smaller mid central MN community. There are several pathology cases that were started by one pathologist or what even seemed to almost be work "hand in hand" with a co-pathologist, that may be horribly, super difficult to bill. So please ~ when in doubt please reach out (even in a query) to your pathology team and ask for for clarification to make sure the provider that should be receiving their RVU's is the provider actually receiving them. I will state unless something is totally awry/amiss with an addendum or even a procedural note that the one signing the pathology report and pathology interpretation "typically" is the usually billing those charge(s) out. I would rather be super clear ensuring any RVU's are appointed to those they actually belong to.
I am unsure why you would need CMS guidance. CMS isn't going to tell you who did the interpretation. Please read your pathology report. I do not understand why some coders find it such a difficult task to communicate with their pathology team(s). GOODNESS, they are just like us. They go to the grocery store, they do errands and wash their clothes, car and clean their homes. My pathology team has ALWAYS stated thank you whenever something wasn't crystal clear. They simply wanted to know how to communicate and make the coder(s) job easier. When I was the president of our local AAPC chapter our Medical Director and Pathologist presented at three of of our May Mania's in a row. She was absolutely brilliant and loved us coders. Now that I am out of school, it is time to bring her back!!
I wish you lots of success pshaw08!! Be the pathology coder THAT every pathologist's really wants. Call me crazy but simply find their mistake ~ why are we undercoding this 8830x when I saw the anesthesia report or operative report state this and should be actually billing 8830x. I cannot tell you the times we changed something based on what I reviewed. We have ALL had that exhaustive day; a pathology code is under or overbilled and we are missing an IHC stain.
Have a great evening!
Thanks for listening,
Dana Chock, RHIT, CPC, CHONC, CPMA, CPB
 

bbooks

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Great advice, Dana! :)

pshaw08, are you responsible for coding the professional and the technical or just the professional? When you say "preparing the slide," do you mean that pathologist is performing the TC portion? These are all specifics you need to clarify with your pathologists. Feel free to post an actual report here. The documentation on the report may help clarify these questions as well.
 

pshaw08

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No i am only billing for the 26 side of it, but we employ 2 pathologist that work together, one will prepare slide and the other will read and dictate. We have the one that is preparing slide wanting to bill for the rvu
 
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