Wiki question on prof code for fallopian tubes for sterilization

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MrsSpiney

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Patient has a C section and has bilat tubal ligation during procedure. Path documentation shows separate specimens for left and right fallopian tube plus the placenta. I am billing for the professional side and the charges drop into my queue from facility side. They are (of late) billing 88304 for fallopian tubes that are sent exclusively related to sterilization, and nothing is found. Am I correct that these should be 88302? I'm needing to justify the credits and downcoding. TIA.
 
I don't know who you report to here, but 88304 is inaccurate from your post to bill. If that seems new to you, you may want to contact your supervisor or pathology team especially if a new person accessioning specimens. Find out your internal policies here and in the meantime if no abnormality noted bill the 88302 if individually identified for each tube. Again, please be cognizant on internal "in house" rules. I some facilities just want you to fix these scenarios whereas others need to know why you are changing/updating charges for RVU analysis.
 
danachock said:
I don't know who you report to here, but 88304 is inaccurate from your post to bill. If that seems new to you, you may want to contact your supervisor or pathology team especially if a new person accessioning specimens. Find out your internal policies here and in the meantime if no abnormality noted bill the 88302 if individually identified for each tube. Again, please be cognizant on internal "in house" rules. I some facilities just want you to fix these scenarios whereas others need to know why you are changing/updating charges for RVU analysis.
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Thank you so much for your feedback. Makes total sense. This scenario was out of the ordinary, which is why I questioned. Appreciate all you do.
 
danachock said:
I don't know who you report to here, but 88304 is inaccurate from your post to bill. If that seems new to you, you may want to contact your supervisor or pathology team especially if a new person accessioning specimens. Find out your internal policies here and in the meantime if no abnormality noted bill the 88302 if individually identified for each tube. Again, please be cognizant on internal "in house" rules. I some facilities just want you to fix these scenarios whereas others need to know why you are changing/updating charges for RVU analysis.
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Dana: I get the 88302 for the fallopian tubes. And the 88304 makes no sense at all, as you say. But would it also be appropriate to code 88307 in addition for the placenta? Just trying to understand here.
 
brucep said:
Dana: I get the 88302 for the fallopian tubes. And the 88304 makes no sense at all, as you say. But would it also be appropriate to code 88307 in addition for the placenta? Just trying to understand here.
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Yes, I was asking specifically on the fallopian tubes but yes claim also needs the 88307 for placenta. Sorry if my question was confusing.
 
Okay, I may have something here or not? 88302 is for sterilization of fallopian tubes. Was a paratubal cyst possibly identified? I am not stating it is accurate here yet. I am just trying to gather all the facts here.
Next, coding 88305 or 88307 (could be multiple) for placenta(s) is totally appropriate depending on trimester and quantity. Let me dig into my resources to find out a little more here now that I have thought about it from a different coding angle. More intel to follow okay.
Dana
 
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