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88341 and 88342 Billing

jonathan Posted Sat 18th of February, 2017 10:36:52 AM
I am new to Pathology billing but wanted to make sure we are billing correctly. Our pathologist is doing a T-10 Bone Core Biopsies because of bone lesions. All claims are modifer 26 for Professional component. She billed 88432 x1 and 88431x11. My question is on how to bill this. Would 88432 be billed just as many as your add on codes 11 times or do you bill 88342x1 and list 88341 11 times on its own line with no modifier.
SuperCoder Answered Mon 20th of February, 2017 08:36:39 AM

Hi,

 

As per the above documentation, appropriate billing would be as under:

 

For example: For T-10 Bone Core Biopsies, as per the MUE, 1 unit of CPT code 88342 and 9 units of 88341 are allowed to be billed on a single day.

 

Billing of CPT 88341 can also be done by reporting 88341 on individual lines to report how many stain procedures were performed.

 

Do check with your payer about the format of reporting CPT 88341 on single claim line with 9 units OR each stain on separate claim lines.

i.e. 88342X1

       88341X9

OR

88342X1

88341 (9 times on each separate claim line).

 

Thank you!

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