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Thread: Tissue Lab Billing for Dermatology

  1. #1

    Default Tissue Lab Billing for Dermatology

    I am hoping someone can help with this question. We are receiving numerous denials from WPS....Medicare for consolidated billing. We have a tissue lab that bills for 88305 mod 26. We prepare the slide only. We did not read out the slide. We prepared the slide for a doctor outside of our dermatology group to read, so we are only performing the technical compotent , but our claims are being denied because the patient just happens to be at a hospital lab that day getting an x-ray, urine test, or blood test, that is totally unrelated to the tissue/skin biopsy sent to our tissue lab. The doctors are totally unrelated.

    How do we prevent these claims from being denied?

    Thank you for any help on this matter.

  2. #2
    Join Date
    Apr 2007
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    15

    Default

    Judy,

    We are having the same problem. Did you ever come to a resolution for this? We are a dermatology practice that processes the pathology in our own pathology lab. We just recently started receiving these denials. We have contacted WPS and they told us they fall under the Consolidated Billing. We went as far as to bill the hospital. Any information that you have is appreciated.

    Thanks,

    Whitney Coverdale, CPC

  3. #3

    Default

    If you are preparing the slide then wouldn't you use the TC modifier and the outside doctor would use the 26? He is doing the report and should be the 26 I would think.

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