Wiki Touch Prep Billing Question

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aleigh

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Hi there,
I have a question about touch prep billing (88333, 88334). We received a left breast sentinel lymph node #1, 2, 3, 4 and right sentinel lymph node #1, 2, 3. There was a touch prep performed on each, it was billed out as 88333 x7, Medicare is only paying for one unit, I believe stating we should bill 88334 for the additional units. I thought 88334 was for additional but on the same specimen? Would appreciate some feedback, thank you.
 
Were there any other charges with the case such as frozen sections? Were each of the sentinel nodes received as separate specimens - that is, seven separate specimens?
 
There were other charges, no frozen sections. 10 specimens in all, but 7 of those were the sentinel lymph nodes separate specimens.
 
From my understanding, it appears you coded this correctly. Can you get any further information about the denial. Might it be helpful to send them a copy of the path report?
 
I've already sent Medicare a copy, they have officially denied my appeal only paying for one unit. :confused:
 
How frustrating. I don't do any billing, so I'm not sure what your next step might be. I hope someone else can help.
 
No worries. Thank you. I've sent a level 2 appeal to Medicare with documentation from the CPT book and other sources so we'll see what that does.
 
I would be interested if you post what sort of reply you get from the appeal.
 
MUE for touch/squash prep

Hi,

I know I'm late to the game on this one, but in Jan 2014 the posted MUE by CMS for cpt 88333 was 4. With proper documentation you should have been paid for no less than 4.

Thanks,
Bran
 
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