Wiki Waiting on path to code

Create Wiki
C

cgifford

Contributor
Messages
19
Location
Mechanicsville, VA
Best answers
0
I work for a dermatologist. The office was of the understanding that you code your BX as d48.5, Neoplasm of uncertain behavior of skin. My thought is to wait until the bx results are in and to code it for what it is. The physician doesn't think we should do that because at the time the bx was perform the diagnosis was D48.5 (uncertain behavior) Unsure on what the right thing to do is, can we legally bill a visit for example 10/01/2015 with a dx we actually didn't receive until 10/03/2015???? any help of where I can find this answer in black and white would be great.
 
Uncertain behavior is not a dx to be used while waiting on path. It is a dx rendered only by path. Look in your code book under the subsection for he D47-D48 codes. These codes classify by site site neoplasm of uncertain behavior. I.e. Histologic confirmation of whether the. Neoplasm is benign or malignant cannot be made.
Histologic confirmation is he path report. You can use these codes only when the path report indicates uncertain behavior or atypical. These are not provider codes they are patient diagnosis codes. These will carry high risk for your patient and can cause financial issues for them.
You hold the claim and wait, and yes it is legal to wait for the response when the procedure was performed on that day even though the response takes a couple of days.
 
You must log in or register to reply here.
Top