Wiki Tumor Board Consults

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andeween

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I have a pathologist who insists that we can issue a report and bill cpt 88321 for cases they pull and review prior to Tumor Board because the information discussed, etc is used for patient care. But, I think that review of tumor board cases fall under everyday resident teaching. I always thought that to bill 88321, there has to be a request from another physician/pathologist/location, etc. to justify billing the 88321. Can anyone offer some insight? I am losing sleep over this.....thanks!
 
Do you have access to the APF's Pathology Service Coding Handbook? If so, read chapter 11. I can't copy/paste , but in essence it says that case reviews for tumor conference aren't typically chargeable. It goes on to say that they may be able to be paid out of the budget for Resident Education or a similar area. Also, I don't know the particulars of your cases but you may need to consider MUE or NCCI edits, too.
Good luck and get some rest!
 
Absolutely no charges in my opinion, Tumor board's pathologist's opinion(s) doesn't change anything. They (pathologist) needs absolutely solid proof another provider requested for their this service.to bill a 88321, 88323 or 88325 . We all have been there. andeween you need to be the educator now. Explain to your pathologist why we can or cannot bill those 8832x codes please. If you need help on this, please respond to my post or please reach out and PM me directly okay?
 
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