Wiki Pathology billing decalcification with 88304

[aleigh]

Hi there,
I'm having an issue with Medicare denying an 88311 when I'm billing it with an 88304, saying the 88304 is not a qualifying primary procedure code. This seems crazy to me, and I can't remember having this issue in the past I called a couple times to see if I received different answers, but one girl did tell me that effective April 2013 it has to be an 83305 to qualify.
So all the decal on bone marrow biopsies/artery, etc. are no longer going to be paid? Anyone have any insight?
Thank you!

 

[JEYCPC]

This is the first I've heard about this. I'll ask around the follow up folks tomorrow.

 

[aleigh]

Thanks, I appreciate it. I've asked our other coder and she is as stumped as I am.

 

[lcabanig]

http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R2636CP.pdf

Here's the publication that was implemented April 2013 regarding add on codes. We are having to do appeals on our 88304's as they are listed as a payable primary code. It's probably some glitch of some sort.