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Pathologist "Filling In"

  1. Talking Pathologist "Filling In"
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    One of my pathologists is filling in for another pathologist at another hospital. The hospital is preparing the slides and sending them to him to examine the slides and prepare a full pathology report.

    Would our pathologist still bill the 883xx codes or use a consultation code of 88321 or 88323? He is not doing a consultation on the slides; however, he is doing all of the professional components for the slides, etc.

    Thanks for ANY and ALL information.
    Julie A. Davenport, CPC -
    Greenwood, SC

  2. #2
    If your pathologist is the first pathologist rendering a diagnosis on the specimen and basing it on any stains, etc. that were done, he or she is not consulting. It's the professional component of whatever was performed. If no one has rendered a diagnosis or interpretation yet, the professional components of the procedure codes are the most accurate description.

    Just like with E/M codes, a pathology consult code is a second opinion, either to confirm or amplify what the original, referring provider concluded or wasn't sure about. If there's no referring provider after an initial pathologic diagnosis, there's no consult. Filling in isn't consulting, it's providing the medically necessary professional component that justifies the technical charges. There's really no reason to have one without the other.

    I hope this logic makes sense.


  3. Default
    Thanks so much for this information. It is very helpful.

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