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coding Pathology from prostate biopsy

Chandra Posted Tue 10th of March, 2015 12:19:48 PM

In an office setting what is the proper way to code the technical part of pathology after an us/bx is done. We use to use 88305 x 12

SuperCoder Answered Wed 11th of March, 2015 04:50:34 AM

Hi,

Please explain where the sample has been tested, whether it was sent to any lab or hospital or done in physician office itself. Also who provided the professional component of the service, whether a physician in your office or by some external pathologist or radiologist.

Thanks.

Chandra Posted Wed 18th of March, 2015 10:24:36 AM

The TC part of the pathology is done in our office. We then send to Bowtwick lab for the "26" Professional intrepretation to be done. We only bill for the technical part of the pathology. I understand how Medicare will cover with the G code but do not know abouth other insurances. BCBSNC is changing code from 88305 to the G code and stating it is experimental.
thanks

SuperCoder Answered Thu 19th of March, 2015 04:09:04 AM

For prostate biopsy performed at your office setting you can bill CPT code 88305 with TC modifier. Bowtwick lab will bill 26 modifier for the professional services performed.

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