I work for a medical lab where we provide slide prep cases and gloabal cases to our clients. One of our client's is a dermatologist who we only slide prep for, he is also reading the professional portion on his side. He has informed me that his biller has billed out cases with the first H&E stain, CPT code of 88305 with a general Dx code of D48.5 the very next day of the surgery. But then once the case is final, and this could be up to 3 weeks later, they bill for the special stains, CPT codes can vary in amount but usually 88312, 88313, 88342 with the final Dx code relating to the case.
I usually only supply the diagnosis codes that relate to the pathologists Dx for my lab only, and although I have been out of the billing side of claims, I never heard of delaying billing. My company always bills only once only when the case is final. This practice bills the 88305 with same dx code for ever case before the labs are final then bills again weeks later for the special stains with the correct Dx ICD-10 code relating to the individual patient's report. My question is this, is this delay and separating billing okay to do, will it decrease any payment, cause more denials, is it even legal?
Any help would be appreciated,
thanks, Lisa
I usually only supply the diagnosis codes that relate to the pathologists Dx for my lab only, and although I have been out of the billing side of claims, I never heard of delaying billing. My company always bills only once only when the case is final. This practice bills the 88305 with same dx code for ever case before the labs are final then bills again weeks later for the special stains with the correct Dx ICD-10 code relating to the individual patient's report. My question is this, is this delay and separating billing okay to do, will it decrease any payment, cause more denials, is it even legal?
Any help would be appreciated,
thanks, Lisa