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DNA QUESTION

Shade Posted Fri 15th of August, 2014 08:08:20 AM

Question: Can we bill insurance for a failed sample?
In our process, we receive tumor and saliva sample from the hospitals. We provide them with sample instructions to give them an idea of how much tissue we need. On occasion, we get samples that fail our quality acceptance criteria toward the end of analysis—so we have done a pathology review, extracted DNA and sequenced the DNA, but the data doesn’t pass, so we fail the case and no report is sent.

Is there something similar on the lab side, like when a tube of blood is sent for a CBC, but something happens to it where the results aren’t accurate?
Are patients still billed for that service? I POSTED THIS QUESTION 2DAYS AGO. I HAVE NOT RECEIVED REPLY. I WILL APPRECIATE AN ANSWER, PLEASE. THANK YOU.

SuperCoder Answered Mon 18th of August, 2014 06:28:18 AM

Thank you for your question, and sorry for the delay. Currently researching.

SuperCoder Answered Mon 18th of August, 2014 06:28:18 AM
Thank you for your question, and sorry for the delay. Currently researching.
Shade Posted Tue 19th of August, 2014 09:38:44 AM

thanks for your response. i will still expect your response on this question. my organization is still expecting an answer from me. i therefore ask for your professional help regarding this question. your help will highly be appreciated. thank you in advance.

SuperCoder Answered Tue 19th of August, 2014 11:40:28 AM

Thank you for allowing us time to look into this. Please see the information below.

SuperCoder Answered Tue 19th of August, 2014 11:40:28 AM
Thank you for your question, and sorry for the delay. Currently researching. You may bill for the service if you are using the surgical pathology codes, with a reduced services modifier, modifier 52. Procedures 88300 through 8839 include accession, handling, and reporting. These three services must be performed if codes 88300 through 88309 are to be listed. If not, then you may wish to use the”-52” reduced service modifier and reduce your charge for the procedure.
SuperCoder Answered Tue 19th of August, 2014 11:40:56 AM

Thank you for your question, and sorry for the delay. Currently researching. You may bill for the service if you are using the surgical pathology codes, with a reduced services modifier, modifier 52.

Procedures 88300 through 8839 include accession, handling, and reporting. These three services must be performed if codes 88300 through 88309 are to be listed. If not, then you may wish to use the”-52” reduced service modifier and reduce your charge for the procedure.

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