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Lost Pathology

  1. Default Lost Pathology
    Medical Coding Books
    What can possibly be done to be reimbursed for a very large skin lesion removed and thought to be malignant but the pathology has been "misplaced"? I will have no definitive diagnosis. Do I have any options for at least a minimal reimbursement? I would appreciate any feedback. Thanks.

  2. #2
    Location
    Milwaukee WI
    Posts
    4,466
    Default What was "misplaced"?
    What - exactly - was "misplaced"? Are we talking the pathology report? Or the actual specimen?

    If it's just the report, contact the pathologist's office and ask for a duplicate.

    If it's the actual specimen .... I would code for benign lesion. I would NEVER give a patient a malignant diagnosis without the pathology report confirming that.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. Default
    Thank you for responding. It was the specimen that was lost. I had the same thoughts as far as using a benign code, but I did not know if I was limited by not having an actual pathology report. There is plenty of documentation as to what happened. I hated for him not to get paid because of someone else's mistake.

  4. #4
    Location
    Columbia, MO
    Posts
    12,837
    Default
    Quote Originally Posted by FTessaBartels View Post
    What - exactly - was "misplaced"? Are we talking the pathology report? Or the actual specimen?

    If it's just the report, contact the pathologist's office and ask for a duplicate.

    If it's the actual specimen .... I would code for benign lesion. I would NEVER give a patient a malignant diagnosis without the pathology report confirming that.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC
    I would not code for benign as you do not have the path for that either. You do not want to send the wrong diagnosis either way. The problem is you do not have a CPT excision code so you are left with a shave code or the biopsy code as the only choice and use a 709.xx code for the dx.

    Debra A. Mitchell, MSPH, CPC-H

  5. Default
    All of the input has been a huge help. I guess some reimbursement is better than none at all. Thanks!

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