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Screening Colonoscopy Pathology billing (Ancillary end)

Sherry Posted Mon 25th of March, 2019 14:38:51 PM
Our GI clinic owns the Pathology as well, so we have a pathologist under our company that does all of our path specimens received; our question is how should the path end of it be billed if the patient has a Screening Colonopscopy done and specimens are collected, does the path end get billed with Z codes as primary? Do they need modifier PT or 33 as well? What if it is a high risk patient and we billed our Colonoscopy with Z80.0 as primary, does the pathology need to be billed as 88305 w/DX code Z80.0 as primary and then the findings?
SuperCoder Answered Tue 26th of March, 2019 07:50:53 AM

Hello Sherry,

Thank you for your question.

 

As per the provided documentation, kindly find the responses highlighted in bold text.

 

how should the path end of it be billed if the patient has a Screening Colonoscopy done and specimens are collected, does the path end get billed with Z codes as primary?  No, the final diagnosis and findings of the pathologist should be reported as the first-listed diagnosis

 

Do they need modifier PT or 33 as well? Modifier PT or 33 should not be appended with code 88305.

 

What if it is a high-risk patient and we billed our Colonoscopy with Z80.0 as primary, does the pathology need to be billed as 88305 w/DX code Z80.0 as primary and then the findings? The final diagnosis and findings of the pathologist should be reported as the first-listed diagnosis.

 

 

Thanks

Please feel free to write if you have any question.

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