Results 1 to 4 of 4

Thread: Consults pathology and medicare

  1. #1

    Default Consults pathology and medicare

    Promo: Code Books
    Billing for the pathologists, 88325, consultation with review of records and specimens, with report on referred material. Medicare will not pay because this is a "consult" code.
    Does anyone have any idea how to bill this to Medicare? They referred us to the E&M codes, but you cant use these......
    Thanks

  2. #2
    Join Date
    Apr 2007
    Location
    New Orleans, LA
    Posts
    160

    Default

    This isn't the kind of consult Medicare should be denying. Appeal with the report but make sure the documentation is strong enough to support 88325. If not, you may only get an 88321 out of it and also a can of worms. It should explicitly say what records were reviewed and how they influenced the final dx.

    Good luck,
    WK

  3. #3
    Join Date
    Apr 2007
    Location
    Magic City - Birmingham, AL
    Posts
    20

    Default

    There was a new ruling by medicare for 2010 on the technical component of 88321 & 88325. The professional is ok, but the technical was going to be denied. 88323 where techs do work up a block or slides still has technical. Other payors may still reimburse. If you need a reference, I'll look it up, I should have saved that info somewhere.

  4. #4

    Default Consults pathology and medicare

    Does anyone have updated information of coding for pathology consults?

Similar Threads

  1. Medicare consults
    By kkerckhoff@alaskaurology.com in forum Billing/Reimbursement
    Replies: 2
    Last Post: 02-18-2015, 03:23 PM
  2. Medicare Consults
    By cocosmoothj in forum E/M
    Replies: 1
    Last Post: 07-30-2010, 01:21 PM
  3. Billing for digital pathology consults
    By ktr in forum Pathology & Clinical Laboratory
    Replies: 3
    Last Post: 06-11-2010, 12:27 PM
  4. Medicare ED Consults
    By jennyjlm in forum Medicare Regulations
    Replies: 2
    Last Post: 02-11-2010, 07:20 AM
  5. Consults/Medicare
    By krssy70 in forum E/M
    Replies: 10
    Last Post: 11-25-2009, 06:43 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.