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Lab Billing

  1. #1
    Default Lab Billing
    Medical Coding Books
    When billing 88305 is it required to have a diagnosis code attached?

  2. #2
    Location
    Louisville, KY
    Posts
    1,101
    Default
    Yes. It is a surgical pathology code--meaning something definitive is required.

    Not to sound stupid, but don't all labs require an ICD for medical necessity?

  3. #3
    Default Lab Billing
    Thanks for the reponse. We think this is obvisous too, but we are dealing with a provider that feels that an ICD 9 is not required when billing an 88305 technical component only. Can you refer me to where this maybe documented? Thanks

  4. #4
    Default
    Section 1842(p)(1)of the Social Security Act requires physicians to report the ICD-9 diagnosis code(s) that explains or justifies the medical necessity of the service or procedure being billed to the Medicare Part B carrier.

  5. #5
    Location
    Everett, WA
    Posts
    10
    Default Icd-9
    Are you billing the insurance company or the provider's office/hospital that did the biopsy? If you are billing the insurance company, it is required to have an ICD-9 code. If you are billing the provider, then it is not necessary.
    Shawna Lumpkin, CPC
    Billing Office Manager/Pathology Coder

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