Christine Posted Tue 21st of July, 2015 10:43:05 AM
When would it be appropriate to use the code 88142-90?
SuperCoder Answered Wed 22nd of July, 2015 01:45:21 AM
Modifier 90 stands for "Reference (Outside) Laboratory". It should be used When laboratory procedures are performed by a party other then the treating or reporting physician. CPT code 88142 states "Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision". So CPT 88142 with 90 modifier should be used in conditions where physician took cervical or vaginal sample and send it to lab for further examination and pathologist interpretate and revert the result to the physician.
Christine Posted Thu 23rd of July, 2015 10:59:32 AM
Would the following scenario fit the above conditions?
The ob-gyn submits the pap to the pathology lab; the case is reviewed by pathology lab.
The pathology lab bills 88142. Are you saying the submitter of the Ob-gyn office can also bill 88142-90? (What if the lab bills an 88175 – can ob-gyn bill 88175-90)
SuperCoder Answered Fri 24th of July, 2015 01:46:03 AM
No, Modifier 90 should only be used by Laboratory if laboratory billing for the test that they did not perform in-house. If they independently performed the test they will bill it without modifier 90. For physician or Ob-gyn office, taking pap smear or cervical or vaginal sample for cytopathology will be considered included in E/M service performed in the office.