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How to bill pathology consultation codes

Leah Posted Mon 11th of January, 2016 11:33:07 AM

Hello,
Our surgeon did a bladder biopsy on a patient. He found the diagnosis listed by the hospital’s pathologist to be confusing. To clarify this diagnosis, he is asking our own in-house pathologist to review the slides. Our pathologist and laboratory manager want to bill 88321, consultation and report on referred slides prepared elsewhere. I want to disagree, because it is not a consultation, it is a second opinion. Secondly, our pathologist and laboratory manager want to bill the patient for 88321. As the request is not driven by the patient, I do not see how that would be proper billing. I have so far not been able to find a sufficient answer researching on my own. Will you please shed some light on this?

Thank you

SuperCoder Answered Tue 12th of January, 2016 05:28:39 AM

Thanks for the Query

88321 states a pathology consultation involves an opinion or advice on the presence or absence of diseased or abnormal tissue provided at the request of another physician. This code report consultations and written interpretations on slide or material referred from another facility or source hence cpt 88321 should be billed for in-house pathologist.

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