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Billing for contracted pathology services

  1. Exclamation Billing for contracted pathology services
    Medical Coding Books
    We are a surgical practice. We had a pathology company contact us recently. They want us to use their pathology company instead of the hospital/ASC. They would come to the Hospital and/or ASC and pick up the specimen(s). Their own coder would assign a CPT code which would be given to us. They would expect us to bill the codes and recive the reimbursement. They would bill us directly. This sounds a little strange and I would assume there would be issues with our insurance companies allowing us to do this since we are contracting the services, not performing them directly. I also assume that teh hospital/ASC would not want us to outsource these services. Anybody heard of this? Anybody doing this? Can you bill for services you do not perfrom directly or suprivise directly?

    Any information would be great!

    Anna Barnes, CPC, CEMC

  2. #2
    Charm City Baltimore
    Red face Late response but hopefully helpful.....
    I know this post is a little late, but in case you were still wondering....

    Yes, my hospital currently has several outside path/lab companies that handle tests for us, that we can't because its not cost effective. However, we do still get to bill for these services b/c our pathologist still interpret most of the results. And while this isn't the case with all of the services, it is for the majority. I actually posted something similar to this topic recently. Looking for feed back from anyone else who may know more about this post or my more recent one: Anatomical pathology coding services.
    Thanks and I hope this was of some help to anyone.....

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