Wiki Pathology


Mount Pleasant, NC
Best answers
Good Morning,
If a sample from a biopsy is obtained and sent to outside facility we can bill the "TC" portion of 88305,correct?

We do have our own lab and pathologist but some samples are sent out for a consult.

Thank you.
no you may bill a TC portion, the Pathologist will be billing global as he is doing all parts. You only package the specimen and send it out.
I have used 51 modifier on a few accounts. I am seeing denials from Medicare. For ‘Missing/incomplete/invalid HCPCS’. Several claims rejected for the same reason. I am stumped since we billed with the XE modifier for separate service from the hospital. How would you like us to work these?
We are an Independent Lab and we are having denials from MCR on claims with CPTs: 88361, or 88344, or 33842, or 88341; in-particular combinations of 88341/88342 we have tried 59, and XU and they remain to be denied. Suggestions would be appreciated. We are stumped.

Would love to also get more information on reading, conversations, etc. on education to help code and bill Pathology. Would someone help us, Please?

Thank you for your help,