Question Surgical & Cyto Pathology Claims

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We are billing CPT 88305 for both cyto and surgical pathology. Must cases are done on the same date of service by different providers. We are billing with the appropriate modifiers, 59 or X series, but they are still being denied as duplicates. Has anyone else had this issue? Were you able to find a better solution to stop the duplicate denials? Currently we are appealing with both reports. Thank you.
 

danachock

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Hi rwhite0115,
Would you able to provide an example please? Simply a brief macroscopic with microscopic with the interpretation for each specimen (with no PHI). When I see "cyto" stated that simply can mean several different things to a pathology coder and I'd like to make sure we are billing the appropriate procedures. Do you also have all the adjustment codes provided from your EOB's? Most people reviewing denials especially focus on the first adjustment code listed but unfortunately it could actually be the second or even the third adjustment code that offers clearer insight on what the actual denial issue may be.
Thanks for listening,
Dana Chock, RHIT, CPC, CANPC, CHONC, CPMA, CPB
(Coding Analyst May 2018-present), (Pathology, Laboratory, Anesthesia Coder Fall 2012-May 2018), (Denial Specialist December 2012-2016)
 
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