[Histonet] Billing for iuds with tissue

[Ann Specian via Histonet]

Can someone tell me the correct way to bill an IUD that has tissue. If there is 
no tissue then we just bill cpt code 88300. If there is tissue should you bill 
88305 or 88300 and 88305?

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[Histonet] Billing for Independent Lab

[Patti Nelson - PN Lab Consultant via Histonet]

Hi Histo Land,


Is there anyone willing to share their wisdom with me regarding Billing for an 
independent lab. If so, please contact me at the phone number below.




Sincerely,

PATTI NELSON  H.T.(ASCP)  
PN  LABORATORY CONSULTANTS
SUPERVISOR DGC/ZADEH LABS
PO BOX 412
CABAZON, CA. 92230
909-841-9761
nelsonr...@verizon.net
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not the addressee, please promptly delete this message and notify the sender 
ofthe delivery error by e-mail or you may call  909-841-9761.

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[Histonet] Billing question help please

[Cassie P. Davis via Histonet]

Good morning Histoland,


  our supervisor came in asking about an regulation she was told about 
this morning that says no more than 9 IHC can be billed on a patient per day. 
Can some one help me find a resource for this?

Cassandra Davis
Histology Technician
AP Laboratory
302-575-8095
Email:  cda...@che-east.org



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[Histonet] Billing Question

[Boyd, Debbie M via Histonet]

A couple scenarios:


1.   FNA with immediate interpretation ( adequacy)  and you make 4 
cytospins from the remaining material?

2.   Three more passes at the same site.  What codes are you using?

3.   What professional CPT codes are you generating.

Thanks.


Debbie M. Boyd l  Chief Histologist, Anatomic Pathology I Southside Regional 
Medical Center  I  200 Medical Park Blvd. I  Petersburg, Va.  23805 I PH: 
804-765-5025 I Fax: 804-765-6058



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Re: [Histonet] Billing Questions

[Cartun, Richard via Histonet]

I can only speak to IHC billing.  My staff (now 2 people) in our IHC Lab does 
all the technical IHC billing manually.  We average about 3,500 billable IHC 
tests per month now.  The volume used to be higher, but our healthcare system 
sold most of our outreach business.

Richard

Richard W. Cartun, MS, PhD
Director, Histology & The Martin M. Berman, MD Immunopathology & Morphologic 
Proteomics Laboratory
Director, Biospecimen Collection Programs
Assistant Director, Anatomic Pathology
Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 972-1596
(860) 545-2204 Fax

-Original Message-
From: Gauch, Vicki via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Wednesday, October 12, 2016 9:19 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing Questions

Hi,
 I've been asked to post a question regarding Pathology technical billing.  
With all of the changes that have been instituted over the past few years on 
the technical billing side in Pathology and the fact that our computer system 
cannot automate  it for us we have been manually billing  our IHC,etc. .  This 
is becoming a real problem since the supervisor and myself are the ones doing 
this and we are also working on the bench along with other duties.
  We are wondering who does that billing in your lab?  Do you have 
biller/coders ? Is it technical staff ?  If it is technical staff, what level  
?  Has anyone been able to get that billing automated?  Any info would be 
greatly appreciated.

Thank you,

Vicki Gauch
AMCH
Albany, NY


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Re: [Histonet] Billing Questions

[Victor via Histonet]

Vicki,

My first question is what computer/LIS system are you using? Are you a private 
lab or part of a hospital? We are in an academic medical center, have our own 
Pathology coders, but all billing is done by the hospital. We generate the 
information for the technical and pro charges and send a daily file. We have a 
team of 3 that run the LIS for Pathology. We use PowerPath and straight out of 
the box, it doesn’t do billing well. A lot of customization over the years and 
ongoing to keep up with changes.

Victor
UWMC
Seattle, WA

Sent from Mail for Windows 10

From: Gauch, Vicki via Histonet
Sent: Wednesday, October 12, 2016 6:19 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing Questions

Hi,
 I've been asked to post a question regarding Pathology technical billing.  
With all of the changes that have been instituted over the past few years on 
the technical billing side in Pathology and the fact that our computer system 
cannot automate  it for us we have been manually billing  our IHC,etc. .  This 
is becoming a real problem since the supervisor and myself are the ones doing 
this and we are also working on the bench along with other duties.
  We are wondering who does that billing in your lab?  Do you have 
biller/coders ? Is it technical staff ?  If it is technical staff, what level  
?  Has anyone been able to get that billing automated?  Any info would be 
greatly appreciated.

Thank you,

Vicki Gauch
AMCH
Albany, NY


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[Histonet] Billing Questions

[Gauch, Vicki via Histonet]

Hi,
 I've been asked to post a question regarding Pathology technical billing.  
With all of the changes that have been instituted over the past few years on 
the technical billing side in Pathology and the fact that our computer system 
cannot automate  it for us we have been manually billing  our IHC,etc. .  This 
is becoming a real problem since the supervisor and myself are the ones doing 
this and we are also working on the bench along with other duties.
  We are wondering who does that billing in your lab?  Do you have 
biller/coders ? Is it technical staff ?  If it is technical staff, what level  
?  Has anyone been able to get that billing automated?  Any info would be 
greatly appreciated.

Thank you,

Vicki Gauch
AMCH
Albany, NY


-
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[Histonet] Billing for skin biopsies

[Vickroy, James via Histonet]

There was a question today that I felt pretty comfortable answering but still 
thought I would see what others have found out on this subject.   
Dermatologists are always asking if there is a lesser pathology charge for a 
skin lesion removed for cosmetic purposes.   My understanding is that while a 
clinician can charge less for removing something for cosmetic purposes once it 
goes to the pathology lab the charges are based on diagnosis and therefore the 
accepted CPT codes are generally 88302 ( plastic repair), 88304 (cyst 
debridement, skin tag) and 88305 for (other than the cyst, debridement, skin 
tag, or plastic repair).   And.we can't charge differently just 
because it was removed for cosmetic purposes.Please let me know your 
thoughts on this and if things are done differently at your institution.

I have told a clinician that they might not have to submit the "cosmetic" skin 
biopsy for pathology however I also don't believe that is a good idea either.

Jim

Jim Vickroy
Histology Manager
Springfield Clinic, Main Campus, East Building
1025 South 6th Street
Springfield, Illinois  62703
Office:  217-528-7541, Ext. 15121
Email:  jvick...@springfieldclinic.com



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[Histonet] billing consults

[Horn, Hazel V via Histonet]

Histonetters,


 1.  Please see the questions about billing for Pathology Consultations under 
varied circumstances as denoted below. For each circumstance, please specify 
whether you bill,
a) professional and technical only, or
b) professional, technical and consult.


 1.  If your response choice is b), please specify whether your payors 
typically pay for the consult charge.
==


 1.  The pathologist to whom the case was assigned has some doubts as to the 
best diagnosis after all attempts to classify the lesion.
 2.  The department has some disagreement about the diagnosis and sends the 
case to another pathologist to help decide the matter.
 3.  The clinician and/or patient requests a second opinion from another 
pathologist.



Hazel Horn
Supervisor of Histology/Autopsy/Transcription
Anatomic Pathology
Arkansas Children's Hospital
1 Children's Way | Slot 820| Little Rock, AR 72202
501.364.4240 direct | 501.364.1241 fax
hor...@archildrens.org
archildrens.org







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Re: [Histonet] billing question

[Weems, Joyce K.]

Breast for margins is an 88307.

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.we...@emoryhealthcare.org



www.saintjosephsatlanta.org
5665 Peachtree Dunwoody Road
Atlanta, GA 30342

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-Original Message-
From: Eck, Allison [mailto:a...@dh.org]
Sent: Monday, June 29, 2015 1:12 PM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] billing question

I am looking for advice on a current billing problem.

Breast specimens: We recieve the lumpectomy with orienting sutures - 88307 
along with that are the accompanying margins (inferior, superior, medial, etc). 
 Our breast surgeon has been placing orienting sutures on all of her margins.  
We had previously been billing under the assumption that the unsutured margins 
were 88305, but now with the sutures should we be billing an 88307 or still 
88305 since they are margins?

Thank you in advance for your help

Allison

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[Histonet] billing question

[Eck, Allison]

I am looking for advice on a current billing problem.

Breast specimens: We recieve the lumpectomy with orienting sutures - 88307
along with that are the accompanying margins (inferior, superior, medial, etc). 
 Our breast surgeon has been placing orienting sutures on all of her margins.  
We had previously been billing under the assumption that the unsutured margins 
were 88305, but now with the sutures should we be billing an 88307 or still 
88305 since they are margins?

Thank you in advance for your help

Allison

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Re: [Histonet] Billing

[Weems, Joyce K.]

Correct



> On May 29, 2015, at 3:13 PM, Vickroy, James  
> wrote:
>
>
> Just need a reminder:
>
> If a pathologist orders the same  several IHC stains on two blocks from the 
> same specimen am I correct to think that we can only charge the stains on one 
> of the blocks? 88342 and the remainder 88341's
>
> Jim
>
> Jim Vickroy
> Histology Manager
> Springfield Clinic, Main Campus, East Building
> 1025 South 6th Street
> Springfield, Illinois  62703
> Office:  217-528-7541, Ext. 15121
> Email:  jvick...@springfieldclinic.com
>
>
>
> This electronic message contains information from Springfield Clinic, LLP 
> that may be confidential, privileged, and/or sensitive. This information is 
> intended for the use of the individual(s) or entity(ies) named above. If you 
> are not the intended recipient, be aware that disclosure, copying, 
> distribution, or action taken on the contents of this information is strictly 
> prohibited. If you have received this electronic message in error, please 
> notify the sender immediately, by electronic mail, so that arrangements may 
> be made for the retrieval of this electronic message. Thank you.
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Re: [Histonet] Billing

[Martha Ward-Pathology]

Yes that is how we do it as well.



 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: Vickroy, James [mailto:jvick...@springfieldclinic.com] 
Sent: Friday, May 29, 2015 3:13 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing


Just need a reminder:

If a pathologist orders the same  several IHC stains on two blocks from the 
same specimen am I correct to think that we can only charge the stains on one 
of the blocks? 88342 and the remainder 88341's

Jim

Jim Vickroy
Histology Manager
Springfield Clinic, Main Campus, East Building
1025 South 6th Street
Springfield, Illinois  62703
Office:  217-528-7541, Ext. 15121
Email:  jvick...@springfieldclinic.com<mailto:jvick...@springfieldclinic.com>



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[Histonet] Billing

[Vickroy, James]

Just need a reminder:

If a pathologist orders the same  several IHC stains on two blocks from the 
same specimen am I correct to think that we can only charge the stains on one 
of the blocks? 88342 and the remainder 88341's

Jim

Jim Vickroy
Histology Manager
Springfield Clinic, Main Campus, East Building
1025 South 6th Street
Springfield, Illinois  62703
Office:  217-528-7541, Ext. 15121
Email:  jvick...@springfieldclinic.com



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Re: [Histonet] Billing question

[Weems, Joyce K.]

Special stains are charged per block. If you have blocks A1, A2, and A3, and do 
AFB and GMS on all three that would be 6 charges.

Sh... this will probably change next year!!

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.we...@emoryhealthcare.org



www.saintjosephsatlanta.org
5665 Peachtree Dunwoody Road
Atlanta, GA 30342

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review, use, disclosure, or distribution is prohibited. If you are not the 
intended recipient, please delete this message, and reply to the sender 
regarding the error in a separate email.

-Original Message-
From: Campbell, Tasha M. [mailto:tmcam...@fmh.org]
Sent: Friday, May 08, 2015 7:51 AM
To: Vickroy, James; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Billing question

>From my understanding its just one charge.  Its per specimen such as A, B, C, 
>etc.  Someone else said that it would be 2 charges so am I wrong on this??  If 
>you did GMS on A1 and AFB on A2 then that would be 2 charges because its two 
>different stains.




Tasha Campbell, B.S.,HTL(ASCP)
Frederick Gastroenterology Associates
310 W. 9th St.
Frederick, MD 21701
301-695-6800 ext. 144 (w)
304-685-9307 (c)

-Original Message-
From: Vickroy, James [mailto:jvick...@springfieldclinic.com]
Sent: Thursday, May 07, 2015 4:58 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing question

If I have two sections on an "A" specimen A1 and A2 and both had a GMS stain, 
do I charge 1 - 88312 or  2 - 88312?

Jim

Jim Vickroy
Histology Manager
Springfield Clinic, Main Campus, East Building
1025 South 6th Street
Springfield, Illinois  62703
Office:  217-528-7541, Ext. 15121
Email:  jvick...@springfieldclinic.com<mailto:jvick...@springfieldclinic.com>



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Re: [Histonet] Billing question

[della Speranza, Vinnie]

This is incorrect. The response from Joyce Weems is correct.

And yes, it's confusing to everyone.



Special stains are billed per block

IHC is billed per specimen



So a GMS on blocks A1 and A2 is GMS charge x 2



If you are not charging special stains per block you are losing revenue you are 
entitled to for 2015



Vinnie Della Speranza | Manager for Anatomic Pathology Services| Medical 
University of South Carolina | 165 Ashley Avenue MSC 908 | Charleston, South 
Carolina 29425 | Office: 843.792.6353 | Fax: 843.792.8974 | del...@musc.edu









-Original Message-
From: Campbell, Tasha M. [mailto:tmcam...@fmh.org]
Sent: Friday, May 08, 2015 7:51 AM
To: Vickroy, James; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Billing question







>From my understanding its just one charge.  Its per specimen such as A, B, C, 
>etc.  Someone else said that it would be 2 charges so am I wrong on this??  If 
>you did GMS on A1 and AFB on A2 then that would be 2 charges because its two 
>different stains.









Tasha Campbell, B.S.,HTL(ASCP)

Frederick Gastroenterology Associates

310 W. 9th St.

Frederick, MD 21701

301-695-6800 ext. 144 (w)

304-685-9307 (c)



-Original Message-

From: Vickroy, James [mailto:jvick...@springfieldclinic.com]

Sent: Thursday, May 07, 2015 4:58 PM

To: histonet@lists.utsouthwestern.edu<mailto:histonet@lists.utsouthwestern.edu>

Subject: [Histonet] Billing question



If I have two sections on an "A" specimen A1 and A2 and both had a GMS stain, 
do I charge 1 - 88312 or  2 - 88312?



Jim



Jim Vickroy

Histology Manager

Springfield Clinic, Main Campus, East Building

1025 South 6th Street

Springfield, Illinois  62703

Office:  217-528-7541, Ext. 15121

Email:  
jvick...@springfieldclinic.com<mailto:jvick...@springfieldclinic.com<mailto:jvick...@springfieldclinic.com%3cmailto:jvick...@springfieldclinic.com>>







This electronic message contains information from Springfield Clinic, LLP that 
may be confidential, privileged, and/or sensitive. This information is intended 
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taken on the contents of this information is strictly prohibited. If you have 
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Re: [Histonet] Billing question

[Campbell, Tasha M.]

>From my understanding its just one charge.  Its per specimen such as A, B, C, 
>etc.  Someone else said that it would be 2 charges so am I wrong on this??  If 
>you did GMS on A1 and AFB on A2 then that would be 2 charges because its two 
>different stains.

 
 
 
Tasha Campbell, B.S.,HTL(ASCP)
Frederick Gastroenterology Associates
310 W. 9th St.
Frederick, MD 21701
301-695-6800 ext. 144 (w)
304-685-9307 (c)

-Original Message-
From: Vickroy, James [mailto:jvick...@springfieldclinic.com] 
Sent: Thursday, May 07, 2015 4:58 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing question

If I have two sections on an "A" specimen A1 and A2 and both had a GMS stain, 
do I charge 1 - 88312 or  2 - 88312?

Jim

Jim Vickroy
Histology Manager
Springfield Clinic, Main Campus, East Building
1025 South 6th Street
Springfield, Illinois  62703
Office:  217-528-7541, Ext. 15121
Email:  jvick...@springfieldclinic.com<mailto:jvick...@springfieldclinic.com>



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Re: [Histonet] Billing question

[Weems, Joyce K.]

2 - specials are per block..

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.we...@emoryhealthcare.org



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5665 Peachtree Dunwoody Road
Atlanta, GA 30342

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-Original Message-
From: Vickroy, James [mailto:jvick...@springfieldclinic.com]
Sent: Thursday, May 07, 2015 4:58 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing question

If I have two sections on an "A" specimen A1 and A2 and both had a GMS stain, 
do I charge 1 - 88312 or  2 - 88312?

Jim

Jim Vickroy
Histology Manager
Springfield Clinic, Main Campus, East Building
1025 South 6th Street
Springfield, Illinois  62703
Office:  217-528-7541, Ext. 15121
Email:  jvick...@springfieldclinic.com<mailto:jvick...@springfieldclinic.com>



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[Histonet] Billing question

[Vickroy, James]

If I have two sections on an "A" specimen A1 and A2 and both had a GMS stain, 
do I charge 1 - 88312 or  2 - 88312?

Jim

Jim Vickroy
Histology Manager
Springfield Clinic, Main Campus, East Building
1025 South 6th Street
Springfield, Illinois  62703
Office:  217-528-7541, Ext. 15121
Email:  jvick...@springfieldclinic.com



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[Histonet] Billing question

[imhyper13]

I have a question about billing practices for special stains and IHC.  We have 
a single billing code for all of our group 1 special stains. (88312).  For 
example, if you order an AFB, GMS and PASF, it would bill as 88312 x 3.  How 
does everyone else bill in this scenario?  We are being told that EACH stain in 
the group 1 needs it's own billing code.  Does anyone else do this?
Thanks
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Re: [Histonet] billing question

[Daniel Schneider]

That's correct, Hazel.

Daniel Schneider, MD
Amarillo, TX

On Thu, Jan 22, 2015 at 3:14 PM, Horn, Hazel V 
wrote:

> Scenario: I am billing for immunostains and there are 3 specimens; A, B, C.
> Pathologist orders 1 stain on all 3 specimens.  I bill 3  88342's.
> Pathologist orders 2 stains each on A and B.  I bill 2  88342's and 2
> 88341's.
>
> Is this correct?
>
> Hazel Horn
> Supervisor of Histology/Autopsy/Transcription
> Anatomic Pathology
> Arkansas Children's Hospital
> 1 Children's Way | Slot 820| Little Rock, AR 72202
> 501.364.4240 direct | 501.364.1241 fax
> hor...@archildrens.org
> archildrens.org
>
>
>
>
>
>
>
>
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[Histonet] billing question

[Horn, Hazel V]

Scenario: I am billing for immunostains and there are 3 specimens; A, B, C.
Pathologist orders 1 stain on all 3 specimens.  I bill 3  88342's.
Pathologist orders 2 stains each on A and B.  I bill 2  88342's and 2  88341's.

Is this correct?

Hazel Horn
Supervisor of Histology/Autopsy/Transcription
Anatomic Pathology
Arkansas Children's Hospital
1 Children's Way | Slot 820| Little Rock, AR 72202
501.364.4240 direct | 501.364.1241 fax
hor...@archildrens.org
archildrens.org







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[Histonet] Billing codes 2015

[rmweber113]

Hi,  I was wondering if anyone has heard of any new billing codes for 2015 in 
regards to cytology, urology pathology or immunohistochemistry.  If so, could 
you please share? 
  
Thanks so much for your help. 
  
Marilynn Weber H.T.(ASCP)QIHC 
Coastal Pathology Consulting Services LLC 
732 814-1170 
fax 267 722-8308 

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[Histonet] Billing Programs

[tissuet...@juno.com]

Hi All   I have a question that I hope someone maybe able to help with: 
 We presently use a billing software program known as EZ Billing and find it to 
be very complicated. I would like to hear from others about what you are using 
and why, we are looking for options to our present system.
 EZ Billing is coupled with AP Easy (our base system) which works well, and 
would like to find another Billing program that will interface with AP Easy 
which we have customized over several years to fit our operation. 
 I am hoping that there is someone out in the Histo world that can provide 
assistance. 
 Please reply to me off line; my office number is 972.241-6277,   
e-mail: fsi...@tissuetechpathology.com
 I thank you in advance for your time and assistance in this matter.
 Respectfully; 
Fred Siena 
Tissue Techniques Pathology Labs

1 Odd trick Kills diabetes
100% scientifically-proven way to control blood sugar in 3 short weeks
http://thirdpartyoffers.juno.com/TGL3141/53a353941576053935483st01vuc
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[Histonet] Billing

[Sarah.Dysart]

When it comes to the medicare codes...question...

So you have one specimen that has 10 blocks.
AE1/AE3 is ordered on all 10 blocks.
Can you bill AE1/AE3 1st Antibody once (G0461), then AE1/AE3 Additional (G0462) 
nine times?

Thanks,

Sarah E. Dysart, BA, HT (ASCP), QIHC (ASCP)
Pathology Supervisor
St. David's North Austin Medical Center
12221 North Mopac Expressway
Austin, Texas  78758
(512)901-1220

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[Histonet] Billing Question

[Adesupo, Adesuyi (Banjo)]

  Hi,
 Please I have a question on the new IHC Billing Policies for CPT, 
Medicare. My question is how do we go about the billing of the HER-2 DUAL ISH 
and the Kappa and Lambda ISH?

   Thanks,

   Banjo Adesuyi, BSMT, HT (ASCP) HTL, QIHC, QLS
   Histology Supervisor
   Norman Regional Health System,
   Norman, OK 73071.
   Tel: 405- 307- 1145

==
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[Histonet] Billing

[Abbott, Tanya]

Does anyone bill for a "technical component" for send outs? Meaning, billing 
for supplies, time it takes to process sendout/receive them back in, etc?
Thanks!

Tanya G. Abbott RT (CSMLS)
Manager Technologist, Histology/Cytology
St. Joseph Medical Center
Reading, PA 19603-0316
ph  610-378-2635
fax 610-898-5871
email: tanyaabb...@catholichealth.net

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[Histonet] Billing for ASR's and RUO's

[Laurie Colbert]

Do hospitals/labs get reimbursed for staining with ASR and RUO antibodies since 
they are not FDA-approved?  What if they are validated in your own lab?

Laurie Colbert, HT (ASCP)
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RE: [Histonet] Billing question

[Gray, Ed]

Professional only 


Ed Gray | Pathology IT Analyst | Phone: 304-293-2945 | Fax 304-293-1627 | WVU 
Healthcare l eg...@wvuhealthcare.com
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message.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Terri Braud
Sent: Friday, November 01, 2013 3:05 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing question

I have a billing question that I would sure like to hear what others are doing, 
please.  In AP billing, when billing for CPT #88321 "Consultation and report on 
referred slides prepared elsewhere"  do you bill both a technical and 
professional component, or professional only?

Any input would be appreciated.  Sincerely, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Holy Redeemer Hospital Laboratory
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3676
Fax: 215-938-3874
-
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[Histonet] Billing question

[Terri Braud]

I have a billing question that I would sure like to hear what others are
doing, please.  In AP billing, when billing for CPT #88321 "Consultation
and report on referred slides prepared elsewhere"  do you bill both a
technical and professional component, or professional only?

Any input would be appreciated.  Sincerely, Terri

Terri L. Braud, HT(ASCP)

Anatomic Pathology Supervisor

Holy Redeemer Hospital Laboratory

1648 Huntingdon Pike

Meadowbrook, PA 19046

Ph: 215-938-3676

Fax: 215-938-3874




-



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RE: [Histonet] Billing ???

[Wanda.Smith]

Good Afternoon to All,
At our hospital, for hospital inpatients and outpatients the Pathologist bill 
for their professional fee and the hospital bills the patients for the 
technical component.  For non-patient specimens (patients seen at other offices 
and facilities), the Pathologist bills the patient globally for both tech and 
pro fee and pays the hospital for the technical services on their industrial 
account.
Hope that helps!
Wanda

WANDA G. SMITH, HTL(ASCP)HT 
Pathology Supervisor 
TRIDENT MEDICAL CENTER 
9330 Medical Plaza Drive 
Charleston, SC  29406 
843-847-4586 
843-847-4296 fax 

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-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of 
jmasla...@stpetes.org
Sent: Friday, June 21, 2013 11:49 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing ???

Happy Friday
This is a question to those who work at a hospital that have contracted 
pathologists. Does your hospital bill the technical component and the 
pathologist bill the profession component or does the pathologist bill 
everything and pay the hospital for technical component?


Joe Maslanka BS, CT,HT (ASCP)
Anatomical Pathology Technical Supervisor

Give thanks for ALL things.
"Kindness is the language the blind can see & the deaf can hear- Mark 
Twain



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RE: [Histonet] Billing ???

[Tom McNemar]

Hospital bills the technical and pathologists bill the professional.

Tom McNemar, HT(ASCP)
Histology Co-ordinator
Licking Memorial Health Systems
(740) 348-4163
(740) 348-4166
tmcne...@lmhealth.org
www.LMHealth.org

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of 
jmasla...@stpetes.org
Sent: Friday, June 21, 2013 11:49 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing ???

Happy Friday
This is a question to those who work at a hospital that have contracted
pathologists. Does your hospital bill the technical component and the
pathologist bill the profession component or does the pathologist bill
everything and pay the hospital for technical component?


Joe Maslanka BS, CT,HT (ASCP)
Anatomical Pathology Technical Supervisor

Give thanks for ALL things.
"Kindness is the language the blind can see & the deaf can hear- Mark
Twain



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RE: [Histonet] Billing ???

[Weems, Joyce K.]

Hospital bills technical and pathologists bill professional

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.we...@emoryhealthcare.org



www.saintjosephsatlanta.org
5665 Peachtree Dunwoody Road
Atlanta, GA 30342

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intended recipient, please delete this message, and reply to the sender 
regarding the error in a separate email.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of 
jmasla...@stpetes.org
Sent: Friday, June 21, 2013 11:49 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing ???

Happy Friday
This is a question to those who work at a hospital that have contracted 
pathologists. Does your hospital bill the technical component and the 
pathologist bill the profession component or does the pathologist bill 
everything and pay the hospital for technical component?


Joe Maslanka BS, CT,HT (ASCP)
Anatomical Pathology Technical Supervisor

Give thanks for ALL things.
"Kindness is the language the blind can see & the deaf can hear- Mark Twain



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RE: [Histonet] Billing ???

[Martha Ward-Pathology]

At our institution the hospital bills the technical and the pathologist bills 
the professional.


 
Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890  
mw...@wakehealth.edu  
 
 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of 
jmasla...@stpetes.org
Sent: Friday, June 21, 2013 11:49 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing ???

Happy Friday
This is a question to those who work at a hospital that have contracted 
pathologists. Does your hospital bill the technical component and the 
pathologist bill the profession component or does the pathologist bill 
everything and pay the hospital for technical component?


Joe Maslanka BS, CT,HT (ASCP)
Anatomical Pathology Technical Supervisor

Give thanks for ALL things.
"Kindness is the language the blind can see & the deaf can hear- Mark Twain



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[Histonet] Billing ???

[JMaslanka]

Happy Friday
This is a question to those who work at a hospital that have contracted 
pathologists. Does your hospital bill the technical component and the 
pathologist bill the profession component or does the pathologist bill 
everything and pay the hospital for technical component?


Joe Maslanka BS, CT,HT (ASCP)
Anatomical Pathology Technical Supervisor

Give thanks for ALL things.
"Kindness is the language the blind can see & the deaf can hear- Mark 
Twain



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RE: [Histonet] Billing for Pin 4 Cocktail

[Vanessa Perez]

Well we use a cocktail, so the antibodies are mixed together and so applied at 
the same time. All in the same dispenser not two diff one.

Vanessa 

-Original Message-
From: Bitting, Angela K. [mailto:akbitt...@geisinger.edu] 
Sent: Monday, March 18, 2013 7:49 AM
To: Vanessa Perez; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Billing for Pin 4 Cocktail

I was given info from a Dako rep last week that if the primary antibodies are 
"applied" separately to the slide as is true with Ventana instruments, you can 
charge for  both.  I am skeptical. Has anyone else heard this?

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vanessa Perez
Sent: Friday, March 15, 2013 12:43 PM
To: histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Billing for Pin 4 Cocktail


Its actually not allowed already.  Any cocktail where all stains are done at 
one time on one slide can only be charged x1 even if its 2 or more antibodys in 
the cocktail.  One of our reps updated us with our PIN cocktail



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Roger Heyna
Sent: Friday, March 15, 2013 11:09 AM
To: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Billing for Pin 4 Cocktail

Our lab currently bills for three, and I know of other labs in our area that 
also bill for three. I have heard rumors that this may not be allowed in the 
near future.
 
Roger Heyna
Maywood, IL

>>> Debbie Granato  3/15/2013 11:00 AM >>>
We have a billing question for the PIN4 Cocktail that we perform on prostate 
needle biopsies.
We currently use the Biocare CK5+CK14+p63 and then add the Biocare P 504S in 
the lab.
How would you bill for this?
Would billing for 1 stain be correct or can you bill for 3 stains?

Thank you for your input.
Debbie Granato

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RE: [Histonet] Billing for Pin 4 Cocktail

[Kuhnla, Melissa]

I always thought you could bill for three due to three distinguishable
staining patterns.  The two cytokeratins can not be distinguished from
each other, therefore three charges instead of four (PIN4).

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Roger
Heyna
Sent: Monday, March 18, 2013 1:11 PM
To: Angela K. Bitting; histonet@lists.utsouthwestern.edu; Vanessa Perez
Subject: RE: [Histonet] Billing for Pin 4 Cocktail

Our billing manager said the same thing. If the antibodies are being
applied separately, you can bill for each one. If antibodies are being
mixed and applied at the same time, you can only bill for one. It sounds
like the difference between a double-stain (two different chromogens)
and a single stain using an antibody cocktail. I still don't think we're
doing it correctly, because we're billing for three, but at least it
sounds like we can bill for two, which seems logical.
 
Have others heard something different?
 
Roger Heyna
Maywood, IL

>>> "Bitting, Angela K."  3/18/2013 7:49 AM >>>
I was given info from a Dako rep last week that if the primary
antibodies are "applied" separately to the slide as is true with Ventana
instruments, you can charge for  both.  I am skeptical. Has anyone else
heard this?

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vanessa
Perez
Sent: Friday, March 15, 2013 12:43 PM
To: histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Billing for Pin 4 Cocktail


Its actually not allowed already.  Any cocktail where all stains are
done at one time on one slide can only be charged x1 even if its 2 or
more antibodys in the cocktail.  One of our reps updated us with our PIN
cocktail



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Roger
Heyna
Sent: Friday, March 15, 2013 11:09 AM
To: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Billing for Pin 4 Cocktail

Our lab currently bills for three, and I know of other labs in our area
that also bill for three. I have heard rumors that this may not be
allowed in the near future.

Roger Heyna
Maywood, IL

>>> Debbie Granato  3/15/2013 11:00 AM >>>
We have a billing question for the PIN4 Cocktail that we perform on
prostate needle biopsies.
We currently use the Biocare CK5+CK14+p63 and then add the Biocare P
504S in the lab.
How would you bill for this?
Would billing for 1 stain be correct or can you bill for 3 stains?

Thank you for your input.
Debbie Granato

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RE: [Histonet] Billing for Pin 4 Cocktail

[Roger Heyna]

Our billing manager said the same thing. If the antibodies are being applied 
separately, you can bill for each one. If antibodies are being mixed and 
applied at the same time, you can only bill for one. It sounds like the 
difference between a double-stain (two different chromogens) and a single stain 
using an antibody cocktail. I still don't think we're doing it correctly, 
because we're billing for three, but at least it sounds like we can bill for 
two, which seems logical.
 
Have others heard something different?
 
Roger Heyna
Maywood, IL

>>> "Bitting, Angela K."  3/18/2013 7:49 AM >>>
I was given info from a Dako rep last week that if the primary antibodies are 
"applied" separately to the slide as is true with Ventana instruments, you can 
charge for  both.  I am skeptical. Has anyone else heard this?

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vanessa Perez
Sent: Friday, March 15, 2013 12:43 PM
To: histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Billing for Pin 4 Cocktail


Its actually not allowed already.  Any cocktail where all stains are done at 
one time on one slide can only be charged x1 even if its 2 or more antibodys in 
the cocktail.  One of our reps updated us with our PIN cocktail



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Roger Heyna
Sent: Friday, March 15, 2013 11:09 AM
To: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Billing for Pin 4 Cocktail

Our lab currently bills for three, and I know of other labs in our area that 
also bill for three. I have heard rumors that this may not be allowed in the 
near future.

Roger Heyna
Maywood, IL

>>> Debbie Granato  3/15/2013 11:00 AM >>>
We have a billing question for the PIN4 Cocktail that we perform on prostate 
needle biopsies.
We currently use the Biocare CK5+CK14+p63 and then add the Biocare P 504S in 
the lab.
How would you bill for this?
Would billing for 1 stain be correct or can you bill for 3 stains?

Thank you for your input.
Debbie Granato

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RE: [Histonet] Billing for Pin 4 Cocktail

[Bitting, Angela K.]

I was given info from a Dako rep last week that if the primary antibodies are 
"applied" separately to the slide as is true with Ventana instruments, you can 
charge for  both.  I am skeptical. Has anyone else heard this?

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vanessa Perez
Sent: Friday, March 15, 2013 12:43 PM
To: histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Billing for Pin 4 Cocktail


Its actually not allowed already.  Any cocktail where all stains are done at 
one time on one slide can only be charged x1 even if its 2 or more antibodys in 
the cocktail.  One of our reps updated us with our PIN cocktail



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Roger Heyna
Sent: Friday, March 15, 2013 11:09 AM
To: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Billing for Pin 4 Cocktail

Our lab currently bills for three, and I know of other labs in our area that 
also bill for three. I have heard rumors that this may not be allowed in the 
near future.
 
Roger Heyna
Maywood, IL

>>> Debbie Granato  3/15/2013 11:00 AM >>>
We have a billing question for the PIN4 Cocktail that we perform on prostate 
needle biopsies.
We currently use the Biocare CK5+CK14+p63 and then add the Biocare P 504S in 
the lab.
How would you bill for this?
Would billing for 1 stain be correct or can you bill for 3 stains?

Thank you for your input.
Debbie Granato

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prohibited and may be unlawful. If you have received this message in error, 
please delete all electronic copies of this message (and the documents attached 
to it, if any), destroy any hard copies you may have created and notify me 
immediately by replying to this email. Thank you.

Geisinger Health System utilizes an encryption process to safeguard Protected 
Health Information and other confidential data contained in external e-mail 
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RE: [Histonet] Billing for Pin 4 Cocktail

[Vanessa Perez]

Its actually not allowed already.  Any cocktail where all stains are done at 
one time on one slide can only be charged x1 even if its 2 or more antibodys in 
the cocktail.  One of our reps updated us with our PIN cocktail



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Roger Heyna
Sent: Friday, March 15, 2013 11:09 AM
To: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Billing for Pin 4 Cocktail

Our lab currently bills for three, and I know of other labs in our area that 
also bill for three. I have heard rumors that this may not be allowed in the 
near future.
 
Roger Heyna
Maywood, IL

>>> Debbie Granato  3/15/2013 11:00 AM >>>
We have a billing question for the PIN4 Cocktail that we perform on prostate 
needle biopsies.
We currently use the Biocare CK5+CK14+p63 and then add the Biocare P 504S in 
the lab.
How would you bill for this?
Would billing for 1 stain be correct or can you bill for 3 stains?

Thank you for your input.
Debbie Granato

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Re: [Histonet] Billing for Pin 4 Cocktail

[Roger Heyna]

Our lab currently bills for three, and I know of other labs in our area that 
also bill for three. I have heard rumors that this may not be allowed in the 
near future.
 
Roger Heyna
Maywood, IL

>>> Debbie Granato  3/15/2013 11:00 AM >>>
We have a billing question for the PIN4 Cocktail that we perform on prostate 
needle biopsies.
We currently use the Biocare CK5+CK14+p63 and then add the Biocare P 504S in 
the lab.
How would you bill for this?
Would billing for 1 stain be correct or can you bill for 3 stains?

Thank you for your input.
Debbie Granato

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[Histonet] Billing for Pin 4 Cocktail

[Debbie Granato]

We have a billing question for the PIN4 Cocktail that we perform on prostate 
needle biopsies.
We currently use the Biocare CK5+CK14+p63 and then add the Biocare P 504S in 
the lab.
How would you bill for this?
 Would billing for 1 stain be correct or can you bill for 3 stains?
 
Thank you for your input.
Debbie Granato
 
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Re: [Histonet] Billing 88342

[Mark Tarango]

I would think that if you're billing the client and not the insurance that
you could charge per block for the technical.  After all you're just
providing the stain to them.  In my opinion, the client should eat this
cost.  I would let the client know that you'd be billing this way before
staining the slides.  They could order 25 stains on a single part and you
would be in the red big time.  If you're billing the patient directly, you
would have to follow the rule of charging only once per specimen.

Mark

On Tue, Jul 3, 2012 at 9:43 AM, Victor A. Tobias  wrote:

> Looking for other opinions from those who do consult/referral work.
>
> If a client sends in a request for a single antibody done on multiple
> blocks on a single specimen, do you bill the client for each tech component
> ? The client will do the interpretation.
>
> What happens in the above scenario if the request is to bill the patient?
> Knowing you get reimbursed for one, do you eat the other charges are make
> the client select the one block?
>
> We have run numbers on potential lost revenue and the number is
> significant.
>
> Victor
>
>
> Victor Tobias HT(ASCP)
> Clinical Applications Analyst
> Harborview Medical Center
> Dept of Pathology Room NJB244
> Seattle, WA 98104
> vtob...@u.washington.edu
> 206-744-2735
> 206-744-8240 Fax
> =
> Privileged, confidential or patient identifiable information may be
> contained in this message. This information is meant only for the use of
> the intended recipients. If you are not the intended recipient, or if the
> message has been addressed to you in error, do not read, disclose,
> reproduce, distribute, disseminate or otherwise use this
> transmission. Instead, please notify the sender by reply e-mail, and then
> destroy all copies of the message and any attachments.
>
> ___
> Histonet mailing list
> Histonet@lists.utsouthwestern.edu
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet
>
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RE: [Histonet] Billing 88342

[Helen Fedor]

That is so true.!

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Paula Pierce
Sent: Tuesday, July 03, 2012 1:36 PM
To: Jay Lundgren; Victor A. Tobias
Cc: HISTONET
Subject: Re: [Histonet] Billing 88342

Where is the like button?


Thumbs up!

 
Paula K. Pierce, HTL(ASCP)HT
President
Excalibur Pathology, Inc.
8901 S. Santa Fe, Suite G
Oklahoma City, OK 73139
405-759-3953 Lab
405-759-7513 Fax
www.excaliburpathology.com



 From: Jay Lundgren 
To: Victor A. Tobias 
Cc: HISTONET 
Sent: Tuesday, July 3, 2012 12:05 PM
Subject: Re: [Histonet] Billing 88342
 
     I am neither a lawyer nor a health care administrator, but, in my 
experience, the Pathologist picks the (hopefully) most diagnostic blocks from 
the multiblock cases and submits them for IHC.  If you do the requested IHC on, 
say, 4 blocks out of 30, you charge x4 for the technical fee.  After all, you 
are using 4 times the supplies (buffer, antibody, etc.).
     Before you hit the cash paying patient with a bill, their primary care 
provider should warn them what it's going to cost.
     I have seen a good Pathologist only select one block for IHC when the 
clinician previously informed him that the patient had no insurance and was 
paying out of pocket.
     I think it's interesting that people control *their own* health care costs 
when no insurance company or the government is involved.

                                           Sincerely,

                                                 Jay A. Lundgren, M.S., HTL
(ASCP)

On Tue, Jul 3, 2012 at 11:43 AM, Victor A. Tobias  wrote:

> Looking for other opinions from those who do consult/referral work.
>
> If a client sends in a request for a single antibody done on multiple 
> blocks on a single specimen, do you bill the client for each tech 
> component ? The client will do the interpretation.
>
> What happens in the above scenario if the request is to bill the patient?
> Knowing you get reimbursed for one, do you eat the other charges are 
> make the client select the one block?
>
> We have run numbers on potential lost revenue and the number is 
> significant.
>
> Victor
>
>
> Victor Tobias HT(ASCP)
> Clinical Applications Analyst
> Harborview Medical Center
> Dept of Pathology Room NJB244
> Seattle, WA 98104
> vtob...@u.washington.edu<mailto:vtob...@u.washington.edu>
> 206-744-2735
> 206-744-8240 Fax
> =
> Privileged, confidential or patient identifiable information may be 
> contained in this message. This information is meant only for the use 
> of the intended recipients. If you are not the intended recipient, or 
> if the message has been addressed to you in error, do not read, 
> disclose, reproduce, distribute, disseminate or otherwise use this 
> transmission. Instead, please notify the sender by reply e-mail, and 
> then destroy all copies of the message and any attachments.
>
> ___
> Histonet mailing list
> Histonet@lists.utsouthwestern.edu
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet
>
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Re: [Histonet] Billing 88342

[Paula Pierce]

Where is the like button?


Thumbs up!

 
Paula K. Pierce, HTL(ASCP)HT
President
Excalibur Pathology, Inc.
8901 S. Santa Fe, Suite G
Oklahoma City, OK 73139
405-759-3953 Lab
405-759-7513 Fax
www.excaliburpathology.com



 From: Jay Lundgren 
To: Victor A. Tobias  
Cc: HISTONET  
Sent: Tuesday, July 3, 2012 12:05 PM
Subject: Re: [Histonet] Billing 88342
 
     I am neither a lawyer nor a health care administrator, but, in my
experience, the Pathologist picks the (hopefully) most diagnostic blocks
from the multiblock cases and submits them for IHC.  If you do the
requested IHC on, say, 4 blocks out of 30, you charge x4 for the technical
fee.  After all, you are using 4 times the supplies (buffer, antibody,
etc.).
     Before you hit the cash paying patient with a bill, their primary care
provider should warn them what it's going to cost.
     I have seen a good Pathologist only select one block for IHC when the
clinician previously informed him that the patient had no insurance and was
paying out of pocket.
     I think it's interesting that people control *their own* health care
costs when no insurance company or the government is involved.

                                           Sincerely,

                                                 Jay A. Lundgren, M.S., HTL
(ASCP)

On Tue, Jul 3, 2012 at 11:43 AM, Victor A. Tobias  wrote:

> Looking for other opinions from those who do consult/referral work.
>
> If a client sends in a request for a single antibody done on multiple
> blocks on a single specimen, do you bill the client for each tech component
> ? The client will do the interpretation.
>
> What happens in the above scenario if the request is to bill the patient?
> Knowing you get reimbursed for one, do you eat the other charges are make
> the client select the one block?
>
> We have run numbers on potential lost revenue and the number is
> significant.
>
> Victor
>
>
> Victor Tobias HT(ASCP)
> Clinical Applications Analyst
> Harborview Medical Center
> Dept of Pathology Room NJB244
> Seattle, WA 98104
> vtob...@u.washington.edu<mailto:vtob...@u.washington.edu>
> 206-744-2735
> 206-744-8240 Fax
> =
> Privileged, confidential or patient identifiable information may be
> contained in this message. This information is meant only for the use of
> the intended recipients. If you are not the intended recipient, or if the
> message has been addressed to you in error, do not read, disclose,
> reproduce, distribute, disseminate or otherwise use this
> transmission. Instead, please notify the sender by reply e-mail, and then
> destroy all copies of the message and any attachments.
>
> ___
> Histonet mailing list
> Histonet@lists.utsouthwestern.edu
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet
>
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Re: [Histonet] Billing 88342

[Jay Lundgren]

 I am neither a lawyer nor a health care administrator, but, in my
experience, the Pathologist picks the (hopefully) most diagnostic blocks
from the multiblock cases and submits them for IHC.  If you do the
requested IHC on, say, 4 blocks out of 30, you charge x4 for the technical
fee.  After all, you are using 4 times the supplies (buffer, antibody,
etc.).
 Before you hit the cash paying patient with a bill, their primary care
provider should warn them what it's going to cost.
 I have seen a good Pathologist only select one block for IHC when the
clinician previously informed him that the patient had no insurance and was
paying out of pocket.
 I think it's interesting that people control *their own* health care
costs when no insurance company or the government is involved.

   Sincerely,

 Jay A. Lundgren, M.S., HTL
(ASCP)

On Tue, Jul 3, 2012 at 11:43 AM, Victor A. Tobias  wrote:

> Looking for other opinions from those who do consult/referral work.
>
> If a client sends in a request for a single antibody done on multiple
> blocks on a single specimen, do you bill the client for each tech component
> ? The client will do the interpretation.
>
> What happens in the above scenario if the request is to bill the patient?
> Knowing you get reimbursed for one, do you eat the other charges are make
> the client select the one block?
>
> We have run numbers on potential lost revenue and the number is
> significant.
>
> Victor
>
>
> Victor Tobias HT(ASCP)
> Clinical Applications Analyst
> Harborview Medical Center
> Dept of Pathology Room NJB244
> Seattle, WA 98104
> vtob...@u.washington.edu
> 206-744-2735
> 206-744-8240 Fax
> =
> Privileged, confidential or patient identifiable information may be
> contained in this message. This information is meant only for the use of
> the intended recipients. If you are not the intended recipient, or if the
> message has been addressed to you in error, do not read, disclose,
> reproduce, distribute, disseminate or otherwise use this
> transmission. Instead, please notify the sender by reply e-mail, and then
> destroy all copies of the message and any attachments.
>
> ___
> Histonet mailing list
> Histonet@lists.utsouthwestern.edu
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>
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[Histonet] Billing 88342

[Victor A. Tobias]

Looking for other opinions from those who do consult/referral work.

If a client sends in a request for a single antibody done on multiple blocks on 
a single specimen, do you bill the client for each tech component
? The client will do the interpretation.

What happens in the above scenario if the request is to bill the patient? 
Knowing you get reimbursed for one, do you eat the other charges are make the 
client select the one block?

We have run numbers on potential lost revenue and the number is significant.

Victor


Victor Tobias HT(ASCP)
Clinical Applications Analyst
Harborview Medical Center
Dept of Pathology Room NJB244
Seattle, WA 98104
vtob...@u.washington.edu
206-744-2735
206-744-8240 Fax
=
Privileged, confidential or patient identifiable information may be contained 
in this message. This information is meant only for the use of the intended 
recipients. If you are not the intended recipient, or if the message has been 
addressed to you in error, do not read, disclose, reproduce, distribute, 
disseminate or otherwise use this
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Re: [Histonet] Billing IHC on MOHS

[Mark Tarango]

Carol,

Its nice to hear this isn't a regular thing.  In reading your original
question, it sounded like you were excited to be charging five times for
those immunos and you were ready to argue for it.  Apparently that was not
the case, you wanted more information and thoughts on the subject.

I once worked for a MOHS surgeon who had billing practices with which I did
not agree.  It was the reason I quit.  I'm glad there are people of high
integrity, such as your group, doing this work.

Mark

On Wednesday, June 20, 2012, Carol Torrence wrote:

> I have nothing more to add regarding this subject but would like to
> address concerns expressed here that touch on fairness, frequency, cost and
> the abilities of techs and surgeons.
>
> ** **
>
> This was a very rare incident involving scar tissue and tumor.  Our Mohs
> lab does not do immunos, our pathology lab does.  My quest was to learn
> more about what constitutes a block.  We stained 5 slides that were the
> same ‘stage’ (one block)….’to be sure there would be no ‘fall offs’. We do
> not want to put the patient through more waiting than necessary.   I was
> not trying to charge for each slide I stained or gouge the patient.  My
> quest was for “correct coding” not what “can” I charge.  I certified as a
> CPC in 2005 but do not practice in that field.  That said, I have a  good
> grasp as to the seriousness of the subject of coding and documentation.***
> *
>
> ** **
>
> I have 30 plus years of experience in histology including management.   I
> have always had the pleasure of working with physicians of high integrity
> and continue to do so in the area of dermatology.  The majority of my time
> has been spent in a large medical center where coding questions could be
> addressed ‘in house’ so to speak.  When I was consulted by the surgeon
> regarding coding this case, our search for the correct coding stems from
> the level of integrity we practice on a daily basis.  I consulted the 
> *American
> Society for Mohs Surgery* (*ASMS*) as was suggested and they do not offer
> coding advice.  I was told that they are an administrative office and
> suggested that I contact AAD.
>
> ** **
>
> Thanks for sharing your thoughts and listening to mine.
>
> ** **
>
> Have a good day!  Onward and upward!
>
> Carol M. Torrence, HT(ASCP)CM 
>
> ctorre...@kmcpa.com ***
> *
>
> ** **
>
> Confidentiality Note: This message is intended for use only by the
> individual or entity to which it is addressed and may contain information
> that is privileged, confidential, and exempt from disclosure under
> applicable law. If the reader of this message is not the intended recipient
> or the employee or agent responsible for delivering the message to the
> intended recipient, you are hereby notified that any dissemination,
> distribution or copying of this communication is strictly prohibited. If
> you have received this communication in error, please contact the sender
> immediately and destroy the material in its entirety, whether electronic or
> hard copy. Thank you
>
> ** **
>
> ** **
>
> * *
>
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RE: [Histonet] Billing IHC on MOHS

[Carol Torrence]

I have nothing more to add regarding this subject but would like to address 
concerns expressed here that touch on fairness, frequency, cost and the 
abilities of techs and surgeons.

 

This was a very rare incident involving scar tissue and tumor.  Our Mohs lab 
does not do immunos, our pathology lab does.  My quest was to learn more about 
what constitutes a block.  We stained 5 slides that were the same ‘stage’ (one 
block)….’to be sure there would be no ‘fall offs’. We do not want to put the 
patient through more waiting than necessary.   I was not trying to charge for 
each slide I stained or gouge the patient.  My quest was for “correct coding” 
not what “can” I charge.  I certified as a CPC in 2005 but do not practice in 
that field.  That said, I have a  good grasp as to the seriousness of the 
subject of coding and documentation.

 

I have 30 plus years of experience in histology including management.   I have 
always had the pleasure of working with physicians of high integrity and 
continue to do so in the area of dermatology.  The majority of my time has been 
spent in a large medical center where coding questions could be addressed ‘in 
house’ so to speak.  When I was consulted by the surgeon regarding coding this 
case, our search for the correct coding stems from the level of integrity we 
practice on a daily basis.  I consulted the American Society for Mohs Surgery 
(ASMS) as was suggested and they do not offer coding advice.  I was told that 
they are an administrative office and suggested that I contact AAD.

 

Thanks for sharing your thoughts and listening to mine.

 

Have a good day!  Onward and upward!

Carol M. Torrence, HT(ASCP)CM 

ctorre...@kmcpa.com

 

Confidentiality Note: This message is intended for use only by the individual 
or entity to which it is addressed and may contain information that is 
privileged, confidential, and exempt from disclosure under applicable law. If 
the reader of this message is not the intended recipient or the employee or 
agent responsible for delivering the message to the intended recipient, you are 
hereby notified that any dissemination, distribution or copying of this 
communication is strictly prohibited. If you have received this communication 
in error, please contact the sender immediately and destroy the material in its 
entirety, whether electronic or hard copy. Thank you

 

 

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Re: [Histonet] Billing IHC on MOHS

[Kim Donadio]

The terminology is confusing< stage and per layer are not the same thing to me, 
depends on how you think about it >. Seems that Moh's and yes I have done this, 
can be done different. You have the Dr Mohs way of getting the what we call 
Donut specimen, which gets inked, nicked, embedded flat then frozen. This is 
your 1st stage. or block "A" if you will. Now some people will cut this into 2 
pieces and even more and this creates more blocks. All of that first specimen 
is still the 1st stage and considered block A. You bill for block A, not for 
A1, A2 etc. and yes you are correct each additional stage( had to go back 
because 1st stage was positive) would be billiable again, same senario above. 
The second stage Block "B" billiable for "B" only, not B1, B2 etc. This was 
something we had much discussion about here as they recently changed multiple 
billing on the same site, or for Mohs you would call it Same Stage. This is my 
interpretation. 
 
and to make sure I am not mis-interpreting you, you're not considering every 
section as you mentioned a seperate stage? While I can see that Carol's post 
has (stage) next to per layer, I have to wonder if this is exactly out of the 
book? Because I would disagree with the two terms meaning the same as well.  
Refer to above comment for my definition of Stage and hopfully it has clarity. 
:)
 
As far as ignoring Medicare, I would never suggest that. And for ignoring 
insurance companies, well you can try all they can do is deny payment and then 
you get to haggle with them. 
 
I'm not sure I can add anything else to this conversation so I will let the 
rest have at it for now. 
 
Hope everyone has a fantastic week! 
 
Kim D
 
 


From: William Chappell 
To: Kim Donadio  
Cc: Carol Torrence ; "histonet@lists.utsouthwestern.edu" 
; 'Ingles Claire'  
Sent: Tuesday, June 19, 2012 9:45 PM
Subject: Re: [Histonet] Billing IHC on MOHS

Well, I don't know if that settles that.

I haven't responded, because I have not worked for a Mohs dermatopahtologist 
who runs Immunos (I have worked at numerous Mohs laboratories), however, this 
explanation is contradictory.  "Each stain is reported only once per block, not 
per slide or per layer (stage)." Yet the definition of a block, "Tissue 
flattened by cutting into pieces, embedded, and frozen in mounting medium used 
by histotechnologists to embed tissue for frozen sections."  Every stage 
represent a new block in which slides are cut.  These two statements are 
contradictory and need clarification.

Now, my own opinion (again I have talked with my dermatopathologist and billing 
specialist and they are as lost as we) is that by definition, Mohs is a frozen 
section diagnosis that must be made by the surgeon (i.e., for a Mohs to be a 
mohs the surgeon removing the tissue must diagnose the tissue -- look it up).  
Every section taken, at every stage is a separate block of the same case.  In 
the event you can charge immunos per case, only one charge can be made.  If it 
can be shown that immunos can be charged per block (per the definition below), 
every immuno on every block from every stage can be charged.

Now for the practicality -- we always start questions like this because 
medicare sets standards for billing that other insurance companies then adopt.  
We should NEVER ask, "what can we charge for," but should always ask, "what 
work did we do that it is fair for a patient to pay for."  Ignore what medicare 
and insurance companies say, bill clients for the work we perform and for the 
results they get.  How much more raw cost is there in staining two Mohs blocks 
with the same immuno?  Is it fair to charge a patient double the amount for 
MUCH less than twice the work?

Will Chappell HTL(ASCP), QIHC

On Jun 19, 2012, at 9:15 PM, Kim Donadio wrote:

> Great team work! Job well done and a absolute answer is given. 
>  
> Thank you 
> 
> 
> 
> From: Carol Torrence 
> To: 'Kim Donadio'  
> Cc: "'Weems, Joyce K.'" ; 'Ingles Claire' 
> ; histonet@lists.utsouthwestern.edu 
> Sent: Tuesday, June 19, 2012 2:10 PM
> Subject: RE: [Histonet] Billing IHC on MOHS
> 
> 
> The following is the response I recived from a coding specialist at the 
> American Academy of Dermatology.  I am trying not to be concerned that the 
> reference is 6 years old but I think it clears up what we thought to be 
> true.  
> 88342 for IHC
> 88314 other “special stains”
> Here is the description for 88314 according to November 2006 cpt Assistant 
> article, the companion piece to the AMA CPT Code Book.
> The work of processing and interpreting one routine stain is included in the 
> procedure 17311- 17315. This stain is usually hematoxylin and eosin, or 
&

[Histonet] Billing IHC on MOHS

[Mark Tarango]

I'm trying to think this through.  Like Will said, if it can be shown that
you can charge immunos per block... I thought we could only charge IHC per
specimen these days.  Wouldn't each stage be a different specimen?  I would
think billing per block of the same stage would be over charging.  Why
would the logic change because this is MOHS?  It is still the same
pathology billing code after all (88342).  I would also think that if this
situation is coming up often that someone is having trouble reading the
H&Es.

Mark

On Tuesday, June 19, 2012, William Chappell wrote:

> Well, I don't know if that settles that.
>
> I haven't responded, because I have not worked for a Mohs
> dermatopahtologist who runs Immunos (I have worked at numerous Mohs
> laboratories), however, this explanation is contradictory.  "Each stain is
> reported only once per block, not per slide or per layer (stage)." Yet the
> definition of a block, "Tissue flattened by cutting into pieces, embedded,
> and frozen in mounting medium used by histotechnologists to embed tissue
> for frozen sections."  Every stage represent a new block in which slides
> are cut.  These two statements are contradictory and need clarification.
>
> Now, my own opinion (again I have talked with my dermatopathologist and
> billing specialist and they are as lost as we) is that by definition, Mohs
> is a frozen section diagnosis that must be made by the surgeon (i.e., for a
> Mohs to be a mohs the surgeon removing the tissue must diagnose the tissue
> -- look it up).  Every section taken, at every stage is a separate block of
> the same case.  In the event you can charge immunos per case, only one
> charge can be made.  If it can be shown that immunos can be charged per
> block (per the definition below), every immuno on every block from every
> stage can be charged.
>
> Now for the practicality -- we always start questions like this because
> medicare sets standards for billing that other insurance companies then
> adopt.  We should NEVER ask, "what can we charge for," but should always
> ask, "what work did we do that it is fair for a patient to pay for."
>  Ignore what medicare and insurance companies say, bill clients for the
> work we perform and for the results they get.  How much more raw cost is
> there in staining two Mohs blocks with the same immuno?  Is it fair to
> charge a patient double the amount for MUCH less than twice the work?
>
> Will Chappell HTL(ASCP), QIHC
>
> On Jun 19, 2012, at 9:15 PM, Kim Donadio wrote:
>
> > Great team work! Job well done and a absolute answer is given.
> >
> > Thank you
> >
> >
> > ____
> > From: Carol Torrence 
> > To: 'Kim Donadio' 
> > Cc: "'Weems, Joyce K.'" ; 'Ingles
> Claire' ; histonet@lists.utsouthwestern.edu
> > Sent: Tuesday, June 19, 2012 2:10 PM
> > Subject: RE: [Histonet] Billing IHC on MOHS
> >
> >
> > The following is the response I recived from a coding specialist at the
> American Academy of Dermatology.  I am trying not to be concerned that the
> reference is 6 years old but I think it clears up what we thought to be
> true.
> > 88342 for IHC
> > 88314 other “special stains”
> > Here is the description for 88314 according to November 2006 cpt
> Assistant article, the companion piece to the AMA CPT Code Book.
> > The work of processing and interpreting one routine stain is included in
> the procedure 17311- 17315. This stain is usually hematoxylin and eosin, or
> toluidine blue. If other special stains are necessary after one routine
> stain, then the code for special stains may be used (88314) as well as
> immunoperoxidase stains (88342) or decalcification procedures (88311).
> Special stains are not typically used and in most Mohs practices are of low
> frequency. Each stain is reported only once per block, not per slide or per
> layer (stage).
> > AMA CPT definition of a Block:Tissue flattened by cutting into pieces,
> embedded, and frozen in mounting medium used by histotechnologists to embed
> tissue for frozen sections.
> > ___
> > Histonet mailing list
> > Histonet@lists.utsouthwestern.edu
> > http://lists.utsouthwestern.edu/mailman/listinfo/histonet
>
>
> ___
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>
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Re: [Histonet] Billing IHC on MOHS

[William Chappell]

Well, I don't know if that settles that.

I haven't responded, because I have not worked for a Mohs dermatopahtologist 
who runs Immunos (I have worked at numerous Mohs laboratories), however, this 
explanation is contradictory.  "Each stain is reported only once per block, not 
per slide or per layer (stage)." Yet the definition of a block, "Tissue 
flattened by cutting into pieces, embedded, and frozen in mounting medium used 
by histotechnologists to embed tissue for frozen sections."  Every stage 
represent a new block in which slides are cut.  These two statements are 
contradictory and need clarification.

Now, my own opinion (again I have talked with my dermatopathologist and billing 
specialist and they are as lost as we) is that by definition, Mohs is a frozen 
section diagnosis that must be made by the surgeon (i.e., for a Mohs to be a 
mohs the surgeon removing the tissue must diagnose the tissue -- look it up).  
Every section taken, at every stage is a separate block of the same case.  In 
the event you can charge immunos per case, only one charge can be made.  If it 
can be shown that immunos can be charged per block (per the definition below), 
every immuno on every block from every stage can be charged.

Now for the practicality -- we always start questions like this because 
medicare sets standards for billing that other insurance companies then adopt.  
We should NEVER ask, "what can we charge for," but should always ask, "what 
work did we do that it is fair for a patient to pay for."  Ignore what medicare 
and insurance companies say, bill clients for the work we perform and for the 
results they get.  How much more raw cost is there in staining two Mohs blocks 
with the same immuno?  Is it fair to charge a patient double the amount for 
MUCH less than twice the work?

Will Chappell HTL(ASCP), QIHC

On Jun 19, 2012, at 9:15 PM, Kim Donadio wrote:

> Great team work! Job well done and a absolute answer is given. 
>  
> Thank you 
> 
> 
> 
> From: Carol Torrence 
> To: 'Kim Donadio'  
> Cc: "'Weems, Joyce K.'" ; 'Ingles Claire' 
> ; histonet@lists.utsouthwestern.edu 
> Sent: Tuesday, June 19, 2012 2:10 PM
> Subject: RE: [Histonet] Billing IHC on MOHS
> 
> 
> The following is the response I recived from a coding specialist at the 
> American Academy of Dermatology.  I am trying not to be concerned that the 
> reference is 6 years old but I think it clears up what we thought to be true. 
>  
> 88342 for IHC
> 88314 other “special stains”
> Here is the description for 88314 according to November 2006 cpt Assistant 
> article, the companion piece to the AMA CPT Code Book.
> The work of processing and interpreting one routine stain is included in the 
> procedure 17311- 17315. This stain is usually hematoxylin and eosin, or 
> toluidine blue. If other special stains are necessary after one routine 
> stain, then the code for special stains may be used (88314) as well as 
> immunoperoxidase stains (88342) or decalcification procedures (88311). 
> Special stains are not typically used and in most Mohs practices are of low 
> frequency. Each stain is reported only once per block, not per slide or per 
> layer (stage).
> AMA CPT definition of a Block:Tissue flattened by cutting into pieces, 
> embedded, and frozen in mounting medium used by histotechnologists to embed 
> tissue for frozen sections.
> ___
> Histonet mailing list
> Histonet@lists.utsouthwestern.edu
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet


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Re: [Histonet] Billing IHC on MOHS

[Kim Donadio]

Great team work! Job well done and a absolute answer is given. 
 
Thank you 
 


 From: Carol Torrence 
To: 'Kim Donadio'  
Cc: "'Weems, Joyce K.'" ; 'Ingles Claire' 
; histonet@lists.utsouthwestern.edu 
Sent: Tuesday, June 19, 2012 2:10 PM
Subject: RE: [Histonet] Billing IHC on MOHS
  

The following is the response I recived from a coding specialist at the 
American Academy of Dermatology.  I am trying not to be concerned that the 
reference is 6 years old but I think it clears up what we thought to be true.  
88342 for IHC
88314 other “special stains”
Here is the description for 88314 according to November 2006 cpt Assistant 
article, the companion piece to the AMA CPT Code Book.
The work of processing and interpreting one routine stain is included in the 
procedure 17311- 17315. This stain is usually hematoxylin and eosin, or 
toluidine blue. If other special stains are necessary after one routine stain, 
then the code for special stains may be used (88314) as well as 
immunoperoxidase stains (88342) or decalcification procedures (88311). Special 
stains are not typically used and in most Mohs practices are of low frequency. 
Each stain is reported only once per block, not per slide or per layer (stage).
AMA CPT definition of a Block:Tissue flattened by cutting into pieces, 
embedded, and frozen in mounting medium used by histotechnologists to embed 
tissue for frozen sections.
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[Histonet] billing IHC on Mohs

[andrea conard]

Mohs or not 88314 is for a special stain. They call this histo chemical
because chemical reactions take place in the tissue. This is not IHC. If
you want to bill for IHC on frozen sections you bill 88342. I just lloked
this up in my trusty coding guide.
Hope that helps or adds to the controversy as the case may me.

Andrea Conard, HT(ASCP), QIHC
Supervisor Anatomic Pathology
AtlantiCare Reginonal Medical Center
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RE: [Histonet] Billing IHC on MOHS

[Carol Torrence]

The following is the response I recived from a coding specialist at the 
American Academy of Dermatology.  I am trying not to be concerned that the 
reference is 6 years old but I think it clears up what we thought to be true.  

88342 for IHC

88314 other “special stains”

Here is the description for 88314 according to November 2006 cpt Assistant 
article, the companion piece to the AMA CPT Code Book.

The work of processing and interpreting one routine stain is included in the 
procedure 17311  - 17315 
 . This stain is usually hematoxylin and 
eosin, or toluidine blue. If other special stains are necessary after one 
routine stain, then the code for special stains may be used (88314 
 ) as well as immunoperoxidase stains (88342 
 ) or decalcification procedures (88311 
 ). Special stains are not typically used 
and in most Mohs practices are of low frequency. Each stain is reported only 
once per block, not per slide or per layer (stage).

AMA CPT definition of a Block: Tissue flattened by cutting into pieces, 
embedded, and frozen in mounting medium used by histotechnologists to embed 
tissue for frozen sections. 

 

 

 

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Re: [Histonet] Billing IHC on MOHS

[Kim Donadio]

Oh I'm hooked. I have got to know the answer now lol we shall conquer this 
problem with your help and then we will all know once and for all. :)
Thank you 

Sent from my iPhone

On Jun 18, 2012, at 6:29 PM, "Carol Torrence"  wrote:

> Kim,
> 
>  
> 
> You are too funny!  It must be controversial if only three of us are talking 
> about it and lots of people are ‘doing it’.  ha! 
> 
>  
> 
> That is funny about the $20… or not.  I was only familiar with 88342 also 
> until I started reading in the MOHS section of said CPT book.  As I read it 
> again, and again, I think I indeed might be interpreting it wrong about being 
> applied to “Immunos”.  We will see what AAD says about my ADD.  Stay tunedJ
> 
> Carol
> 
>  
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RE: [Histonet] Billing IHC on MOHS

[Carol Torrence]

Kim,

 

You are too funny!  It must be controversial if only three of us are talking
about it and lots of people are 'doing it'.  ha!  

 

That is funny about the $20. or not.  I was only familiar with 88342 also
until I started reading in the MOHS section of said CPT book.  As I read it
again, and again, I think I indeed might be interpreting it wrong about
being applied to "Immunos".  We will see what AAD says about my ADD.  Stay
tunedJ

Carol

 

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Re: [Histonet] Billing IHC on MOHS

[Kim Donadio]

Carol, 
   I obvioulsy have a talent for getting involved in controversial 
subjects, I really got to stop that LOL 
 
I used to have a CPT manual but no longer,they are very handy. If you got it 
out of that it seems to me thats the golden rule. My concern for you was that 
they recently changed how many you could bill per site. We had great discussion 
on it here. As I am not familiar with 88314 and got little info when I tried to 
look it up, coder wanted 20 bucks from me to see it. I am aware that Mohs has 
some codes specifically for Mohs, but my understanding is that CPT's are 
universal and each antibody would be 88342. However if your cpt manual says 
specifically a Mohs fs + antibody is 88314 I can only imagine the reimbursment 
for the frozen is included? I cant imagine why they would have a seperate one. 
Also when I was looking at what little coder would let me see for 88314, the 
termonology caught my eye. When I think histochemical stain , I think stains 
like a iron or trichrome or something of that nature. Thats why I mentioned 
88342 because its specifically for
 immunohistochemistry, each antibody. 
 
Well, I hope I havnt made this clear as mud. I have no perfect answer just my 
thoughts. I am eager to hear what AAD says so keep us up to date. 
 
Thanks
 
Kim D
 


 From: Carol Torrence 
To: 'Kim Donadio'  
Cc: "'Weems, Joyce K.'" ; 'Ingles Claire' 
; histonet@lists.utsouthwestern.edu 
Sent: Monday, June 18, 2012 5:23 PM
Subject: RE: [Histonet] Billing IHC on MOHS
  
Thanks everyone.  
I quoted the description straight from the PMIC coding manual.  It is for
use with 17311-17315, 88302-88309, 33221, and 88332.  I was hoping to get a
discussion about Mohs mysteries.  I have also found it in two other
publications. Mohs Society referred me AAD and I am waiting for an email
response.

After reviewing the slides that were given to our lab for staining I
discovered that all five slides were from a single block containing two
margins on each slide.  I charged 88314-59.

Kim you bring up another often controversial subject...when to charge 88307
or 88309. I became a CPC in 2005 but have found that if "you don't use you
lose it and if notthey will change the rules on you anyway".  Ha!

I appreciate all comment. 
Carol T 

-Original Message-
From: Kim Donadio [mailto:one_angel_sec...@yahoo.com] 
Sent: Saturday, June 16, 2012 10:40 AM
To: Carol Torrence
Cc: Weems, Joyce K.; Ingles Claire; 
Subject: Re: [Histonet] Billing IHC on MOHS

I'd be very careful with this. Histochemical even if it's on frozen section
such as 88314 does not mean immunohistochemical which is 88342 to my
understanding. To my understanding anytime you use a antibody it's a 88342
code. Now as far as being able to code for each margin say from 3-6 or 6-9
o'clock etc that seems like it would fall under the rules for each site to
me kind of like we would charge a 88307 or 88309 for excision with margins
instead of a 88305 which pays less. I personally recommend this not be left
in the hands of google or even histonet. Good information comes from both
but you might just want to put a call into American society of MOHs and ask.
Because over billing is serious business and can get you in a lot of
trouble. I only say this because usually in MOHs you'll get the whole
specimen which your checking for margins. Then any piece after that would be
a separate specimen example that would be part " B " which you could charge
separate for.  And since different docs do this differently making a call
couldn't hurt then you could come and share what they say with us :) 

Sent from my iPhone

On Jun 15, 2012, at 2:20 PM, "Carol Torrence"  wrote:

> By George I've got it! This is what I read from "Coder's Choice CPT Plus"
> 
> 88314 is for IHC performed on frozen tissue...when a nonroutine 
> histochemical stain on frozen tissue during Mohs surgery is utilized, 
> report
> 88314 with modifier 59.  Report one unit of 88314 for each special 
> stain on each frozen surgical pathology block.
> 
> Carol M. Torrence, HT(ASCP)CM
> Director of Laboratory Services
> KMC Dermatology - Pathology
> 2921 SW Wanamaker Dr.
> Topeka, Kansas 66614-5334
> 785-273-2788 ext 328
> fax 785-272-6185
> ctorre...@kmcpa.com
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
> ___
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RE: [Histonet] Billing IHC on MOHS

[Carol Torrence]

Thanks everyone.  
I quoted the description straight from the PMIC coding manual.  It is for
use with 17311-17315, 88302-88309, 33221, and 88332.  I was hoping to get a
discussion about Mohs mysteries.  I have also found it in two other
publications. Mohs Society referred me AAD and I am waiting for an email
response.

After reviewing the slides that were given to our lab for staining I
discovered that all five slides were from a single block containing two
margins on each slide.  I charged 88314-59.

Kim you bring up another often controversial subject...when to charge 88307
or 88309. I became a CPC in 2005 but have found that if "you don't use you
lose it and if notthey will change the rules on you anyway".  Ha!

I appreciate all comment. 
Carol T 

-Original Message-
From: Kim Donadio [mailto:one_angel_sec...@yahoo.com] 
Sent: Saturday, June 16, 2012 10:40 AM
To: Carol Torrence
Cc: Weems, Joyce K.; Ingles Claire; 
Subject: Re: [Histonet] Billing IHC on MOHS

I'd be very careful with this. Histochemical even if it's on frozen section
such as 88314 does not mean immunohistochemical which is 88342 to my
understanding. To my understanding anytime you use a antibody it's a 88342
code. Now as far as being able to code for each margin say from 3-6 or 6-9
o'clock etc that seems like it would fall under the rules for each site to
me kind of like we would charge a 88307 or 88309 for excision with margins
instead of a 88305 which pays less. I personally recommend this not be left
in the hands of google or even histonet. Good information comes from both
but you might just want to put a call into American society of MOHs and ask.
Because over billing is serious business and can get you in a lot of
trouble. I only say this because usually in MOHs you'll get the whole
specimen which your checking for margins. Then any piece after that would be
a separate specimen example that would be part " B " which you could charge
separate for.  And since different docs do this differently making a call
couldn't hurt then you could come and share what they say with us :) 

Sent from my iPhone

On Jun 15, 2012, at 2:20 PM, "Carol Torrence"  wrote:

> By George I've got it! This is what I read from "Coder's Choice CPT Plus"
> 
> 88314 is for IHC performed on frozen tissue...when a nonroutine 
> histochemical stain on frozen tissue during Mohs surgery is utilized, 
> report
> 88314 with modifier 59.  Report one unit of 88314 for each special 
> stain on each frozen surgical pathology block.
> 
> Carol M. Torrence, HT(ASCP)CM
> Director of Laboratory Services
> KMC Dermatology - Pathology
> 2921 SW Wanamaker Dr.
> Topeka, Kansas 66614-5334
> 785-273-2788 ext 328
> fax 785-272-6185
> ctorre...@kmcpa.com
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
> ___
> Histonet mailing list
> Histonet@lists.utsouthwestern.edu
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet




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Re: [Histonet] Billing IHC on MOHS

[Kim Donadio]

I'd be very careful with this. Histochemical even if it's on frozen section 
such as 88314 does not mean immunohistochemical which is 88342 to my 
understanding. To my understanding anytime you use a antibody it's a 88342 
code. Now as far as being able to code for each margin say from 3-6 or 6-9 
o'clock etc that seems like it would fall under the rules for each site to me 
kind of like we would charge a 88307 or 88309 for excision with margins instead 
of a 88305 which pays less. I personally recommend this not be left in the 
hands of google or even histonet. Good information comes from both but you 
might just want to put a call into American society of MOHs and ask. Because 
over billing is serious business and can get you in a lot of trouble. I only 
say this because usually in MOHs you'll get the whole specimen which your 
checking for margins. Then any piece after that would be a separate specimen 
example that would be part " B " which you could charge separate for.  And 
since different docs do this differently making a call couldn't hurt then you 
could come and share what they say with us :) 

Sent from my iPhone

On Jun 15, 2012, at 2:20 PM, "Carol Torrence"  wrote:

> By George I've got it! This is what I read from "Coder's Choice CPT Plus"
> 
> 88314 is for IHC performed on frozen tissue...when a nonroutine
> histochemical stain on frozen tissue during Mohs surgery is utilized, report
> 88314 with modifier 59.  Report one unit of 88314 for each special stain on
> each frozen surgical pathology block.
> 
> Carol M. Torrence, HT(ASCP)CM 
> Director of Laboratory Services
> KMC Dermatology - Pathology
> 2921 SW Wanamaker Dr.
> Topeka, Kansas 66614-5334
> 785-273-2788 ext 328  
> fax 785-272-6185
> ctorre...@kmcpa.com
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
> ___
> Histonet mailing list
> Histonet@lists.utsouthwestern.edu
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet

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RE: [Histonet] Billing IHC on MOHS

[Weems, Joyce K.]

Well, actually I was thinking immunos on the paraffin block from the frozen.. I 
guess you all do it on frozen tho!!

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.we...@emoryhealthcare.org



www.saintjosephsatlanta.org
5665 Peachtree Dunwoody Road
Atlanta, GA 30342

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intended recipient, please delete this message, and reply to the sender 
regarding the error in a separate email.


-Original Message-
From: Carol Torrence [mailto:ctorre...@kmcpa.com]
Sent: Friday, June 15, 2012 2:20 PM
To: Weems, Joyce K.; 'Ingles Claire '; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Billing IHC on MOHS

By George I've got it! This is what I read from "Coder's Choice CPT Plus"

88314 is for IHC performed on frozen tissue...when a nonroutine 
histochemical stain on frozen tissue during Mohs surgery is utilized, report
88314 with modifier 59.  Report one unit of 88314 for each special stain on 
each frozen surgical pathology block.

Carol M. Torrence, HT(ASCP)CM
Director of Laboratory Services
KMC Dermatology - Pathology
2921 SW Wanamaker Dr.
Topeka, Kansas 66614-5334
785-273-2788 ext 328
fax 785-272-6185
ctorre...@kmcpa.com













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RE: [Histonet] Billing IHC on MOHS

[Weems, Joyce K.]

See, I even forgot the CPT code was 314!! Yeah, you.. so glad you found that 
for all the Mohs folks..

Have a good weekend everybody...

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.we...@emoryhealthcare.org



www.saintjosephsatlanta.org
5665 Peachtree Dunwoody Road
Atlanta, GA 30342

This e-mail, including any attachments is the property of Saint Joseph's 
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intended recipient, please delete this message, and reply to the sender 
regarding the error in a separate email.


-Original Message-
From: Carol Torrence [mailto:ctorre...@kmcpa.com]
Sent: Friday, June 15, 2012 2:20 PM
To: Weems, Joyce K.; 'Ingles Claire '; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Billing IHC on MOHS

By George I've got it! This is what I read from "Coder's Choice CPT Plus"

88314 is for IHC performed on frozen tissue...when a nonroutine 
histochemical stain on frozen tissue during Mohs surgery is utilized, report
88314 with modifier 59.  Report one unit of 88314 for each special stain on 
each frozen surgical pathology block.

Carol M. Torrence, HT(ASCP)CM
Director of Laboratory Services
KMC Dermatology - Pathology
2921 SW Wanamaker Dr.
Topeka, Kansas 66614-5334
785-273-2788 ext 328
fax 785-272-6185
ctorre...@kmcpa.com













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RE: [Histonet] Billing IHC on MOHS

[Carol Torrence]

By George I've got it! This is what I read from "Coder's Choice CPT Plus"

88314 is for IHC performed on frozen tissue...when a nonroutine
histochemical stain on frozen tissue during Mohs surgery is utilized, report
88314 with modifier 59.  Report one unit of 88314 for each special stain on
each frozen surgical pathology block.

Carol M. Torrence, HT(ASCP)CM 
Director of Laboratory Services
KMC Dermatology - Pathology
2921 SW Wanamaker Dr.
Topeka, Kansas 66614-5334
785-273-2788 ext 328  
fax 785-272-6185
ctorre...@kmcpa.com

 


 
 





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RE: [Histonet] Billing IHC on MOHS

[Carol Torrence]

Thanks.  I agree.  Maybe we will hear from some derm labs today. My doctor
wants to play it safe and charge once but that sure doesn't come close to
covering costs of staining 5 slides, all different sites of the same lesion.
It sounds like we can all argue both sides of the fence.
 
Carol M. Torrence, HT(ASCP)CM 
ctorre...@kmcpa.com

 


 





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RE: [Histonet] Billing IHC on MOHS

[Weems, Joyce K.]

I was hoping someone else would jump in here that knows more about Mohs. I'm 
not sure if they are handled differently than other specimens because we don't 
do them. It seems that whatever is removed for separate dx would be billed as 
separate specimens, but there's not a lot of logic to this system!

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.we...@emoryhealthcare.org



www.saintjosephsatlanta.org
5665 Peachtree Dunwoody Road
Atlanta, GA 30342

This e-mail, including any attachments is the property of Saint Joseph's 
Hospital and is intended for the sole use of the intended recipient(s).  It may 
contain information that is privileged and confidential.  Any unauthorized 
review, use, disclosure, or distribution is prohibited. If you are not the 
intended recipient, please delete this message, and reply to the sender 
regarding the error in a separate email. 


-Original Message-
From: Ingles Claire [mailto:cing...@uwhealth.org] 
Sent: Thursday, June 14, 2012 3:33 PM
To: Weems, Joyce K.; Carol Torrence; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Billing IHC on MOHS

Is this per "Specimen" or per surgical site. Mohs specimens are usually cut 
into smaller pieces and inked after the excision is removed. I would think this 
constitutes x# of blocks from the same specimen. Same as an excision that is 
breadloafed into separate sections. I don't think it matters who does the 
cutting, although when we send these to path for permenents they are logged in 
a separate specimens but only measured, never breadloafed.  Is it more 
dependent on how it is received in the lab even though the end result is still 
the same? 
Claire



From: histonet-boun...@lists.utsouthwestern.edu on behalf of Weems, Joyce K.
Sent: Thu 6/14/2012 2:20 PM
To: 'Carol Torrence'; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Billing IHC on MOHS



If each location is identified as a separate specimen, you can bill per 
specimen, is the way I understand it.


e.g.
Received separately - 88342 x 4

3:00 margin - A
6:00 margin - B
9:00 margin - C
12:00 margin - D

If one specimen is received and divided into separate cassettes  - 88342 x 1
A1 - 3:00 margin
A2 - 6:00 margin
A3 - 9:00 margin
A4 - 12:00 margin

Best, $1,783.00

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.we...@emoryhealthcare.org



www.saintjosephsatlanta.org
5665 Peachtree Dunwoody Road
Atlanta, GA 30342

This e-mail, including any attachments is the property of Saint Joseph's 
Hospital and is intended for the sole use of the intended recipient(s).  It may 
contain information that is privileged and confidential.  Any unauthorized 
review, use, disclosure, or distribution is prohibited. If you are not the 
intended recipient, please delete this message, and reply to the sender 
regarding the error in a separate email.


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Carol Torrence
Sent: Thursday, June 14, 2012 2:37 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing IHC on MOHS

I have a question about billing IHC on MOHS.  When I go through the coding 
rules..I can defend it either way... I think. Ha!  If you are doing the same 
antibody on one site with 5 individual zones, taking 5 independently labeled
slides and each zone requires evaluation before continuing surgery.   Do you
charge 88342 times 5 or just once.  I understand it would be just once if this 
was a routine surgical specimen but this is a horse of a different color.



For example.  Even for frozen sections performed during surgery, additional 
margins can be charged as additional frozen sections.


Thanks in advance!



Carol M. Torrence, HT(ASCP)CM



ctorre...@kmcpa.com





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RE: [Histonet] Billing IHC on MOHS

[Ingles Claire]

Is this per "Specimen" or per surgical site. Mohs specimens are usually cut 
into smaller pieces and inked after the excision is removed. I would think this 
constitutes x# of blocks from the same specimen. Same as an excision that is 
breadloafed into separate sections. I don't think it matters who does the 
cutting, although when we send these to path for permenents they are logged in 
a separate specimens but only measured, never breadloafed.  Is it more 
dependent on how it is received in the lab even though the end result is still 
the same? 
Claire



From: histonet-boun...@lists.utsouthwestern.edu on behalf of Weems, Joyce K.
Sent: Thu 6/14/2012 2:20 PM
To: 'Carol Torrence'; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Billing IHC on MOHS



If each location is identified as a separate specimen, you can bill per 
specimen, is the way I understand it.


e.g.
Received separately - 88342 x 4

3:00 margin - A
6:00 margin - B
9:00 margin - C
12:00 margin - D

If one specimen is received and divided into separate cassettes  - 88342 x 1
A1 - 3:00 margin
A2 - 6:00 margin
A3 - 9:00 margin
A4 - 12:00 margin

Best, $1,783.00

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.we...@emoryhealthcare.org



www.saintjosephsatlanta.org
5665 Peachtree Dunwoody Road
Atlanta, GA 30342

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Hospital and is intended for the sole use of the intended recipient(s).  It may 
contain information that is privileged and confidential.  Any unauthorized 
review, use, disclosure, or distribution is prohibited. If you are not the 
intended recipient, please delete this message, and reply to the sender 
regarding the error in a separate email.


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Carol Torrence
Sent: Thursday, June 14, 2012 2:37 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing IHC on MOHS

I have a question about billing IHC on MOHS.  When I go through the coding 
rules..I can defend it either way... I think. Ha!  If you are doing the same 
antibody on one site with 5 individual zones, taking 5 independently labeled
slides and each zone requires evaluation before continuing surgery.   Do you
charge 88342 times 5 or just once.  I understand it would be just once if this 
was a routine surgical specimen but this is a horse of a different color.



For example.  Even for frozen sections performed during surgery, additional 
margins can be charged as additional frozen sections.


Thanks in advance!



Carol M. Torrence, HT(ASCP)CM



ctorre...@kmcpa.com





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RE: [Histonet] Billing IHC on MOHS

[Weems, Joyce K.]

If each location is identified as a separate specimen, you can bill per 
specimen, is the way I understand it.


e.g.
Received separately - 88342 x 4

3:00 margin - A
6:00 margin - B
9:00 margin - C
12:00 margin - D

If one specimen is received and divided into separate cassettes  - 88342 x 1
A1 - 3:00 margin
A2 - 6:00 margin
A3 - 9:00 margin
A4 - 12:00 margin

Best, $1,783.00

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.we...@emoryhealthcare.org



www.saintjosephsatlanta.org
5665 Peachtree Dunwoody Road
Atlanta, GA 30342

This e-mail, including any attachments is the property of Saint Joseph's 
Hospital and is intended for the sole use of the intended recipient(s).  It may 
contain information that is privileged and confidential.  Any unauthorized 
review, use, disclosure, or distribution is prohibited. If you are not the 
intended recipient, please delete this message, and reply to the sender 
regarding the error in a separate email.


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Carol Torrence
Sent: Thursday, June 14, 2012 2:37 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Billing IHC on MOHS

I have a question about billing IHC on MOHS.  When I go through the coding 
rules..I can defend it either way... I think. Ha!  If you are doing the same 
antibody on one site with 5 individual zones, taking 5 independently labeled
slides and each zone requires evaluation before continuing surgery.   Do you
charge 88342 times 5 or just once.  I understand it would be just once if this 
was a routine surgical specimen but this is a horse of a different color.



For example.  Even for frozen sections performed during surgery, additional 
margins can be charged as additional frozen sections.


Thanks in advance!



Carol M. Torrence, HT(ASCP)CM



ctorre...@kmcpa.com





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[Histonet] Billing IHC on MOHS

[Carol Torrence]

I have a question about billing IHC on MOHS.  When I go through the coding
rules..I can defend it either way... I think. Ha!  If you are doing the same
antibody on one site with 5 individual zones, taking 5 independently labeled
slides and each zone requires evaluation before continuing surgery.   Do you
charge 88342 times 5 or just once.  I understand it would be just once if
this was a routine surgical specimen but this is a horse of a different
color.  

 

For example.  Even for frozen sections performed during surgery, additional
margins can be charged as additional frozen sections.


Thanks in advance!

 

Carol M. Torrence, HT(ASCP)CM 

 

ctorre...@kmcpa.com

 

 

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[Histonet] Billing for stereotactic breast biopsies in core containers

[Vickroy, Jim]

How are people billing these?   Currently we are billing as one 88305 however I 
am wondering if others are billing for each well separately.  (such as 6 
o'clock, 9'oclock, 12'oclock, 3 o'clock, and center well).



James Vickroy BS, HT(ASCP)

Surgical  and Autopsy Pathology Technical Supervisor
Memorial Medical Center
217-788-4046



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[Histonet] Billing Question

[Wilson A]

 
  Hi,
 Please I will appreciate it, if you guys could tell me what you 
usually charge for the following;
    1. Touch Prep
    2. Cutting extral slides for send out.
 
 I thank you all for the good job.
 
   Wilson.
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[Histonet] Billing for Surgical Pathology

[Vickroy, Jim]

Billing question -   I have read and understand the CPT codes for surgical 
pathology specimens including bundling, etc.   I also understand that we can 
bill a CPT code for each separate specimen. (I know there may be exceptions.)

What I don't clearly understand is the "Modifier" side of all of this.   
Example:

Let's say we have four gi biopsies (asc. Colon bx, desc colon bs, esophageal 
bx, and a rectal bx.
In our system we would enter 4 - 88305's.   Where the argument and question has 
come is that do we have to add a modifier to these specimens since there are 
multiple specimens?

Some sources we have say that since they are separately submitted specimens 
that a modifier is not needed.  Someone else today said that the first of the 
four specimens does not need a modifier but the remaining four do.

Can anyone shed some light on this?   We have counted on our billing department 
to be the specialists on this stuff but now that is in question.

Jim

James Vickroy BS, HT(ASCP)

Surgical  and Autopsy Pathology Technical Supervisor
Memorial Medical Center
217-788-4046



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[Histonet] BILLING FOR PATH

[SHANE NELSON]

Can anyone help me answer some questions regarding CPT billing for pathology? I 
would be so ever greatful.
If you can please email me and I can be more specific.
 
THANK YOU,
 
PATTI RUBEN-NELSON  H.T.(ASCP) 
P.O. BOX 412
CABAZON, CA. 92230
cell (909) 841-9761 
nelsonr...@verizon.net
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[Histonet] Billing for CD3/20

[Matthew Lunetta]

Hey all,
We are looking at doing the double stain CD3/20 and wanted to know how everyone 
is billing for it. Can we bill for 2 immuno stains? Or do we have to bill for 
one? What is the proper CPT for doing double or even triple staining? We are a 
Medicare facility.
Thanks
Matt Lunetta BS HT(ASCP)
Longmont United Hospital
Longmont, Colorado
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[Histonet] billing

[anita dudley]

for those of you that are doing her2 immunos,  are you charging more for these 
than for other antibodies?  I pay way more for these, and it seems we should be 
able to charge more?  thanks,  everyone have a great weekend!!
 
anita dudley
providence hospital
mobile, alabama 
  
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RE: [Histonet] Billing question

[Houston, Ronald]

We've been repeatedly told by Compliance that if a pathologist (or a clinician) 
orders a test, the test result must be included in the report and the test must 
be billed for; even if the result is non-contributory.


Ronnie Houston
Anatomic Pathology Manager
Nationwide Children's Hospital
Columbus OH 43205
(614) 722 5450

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Drew Meyer
Sent: Thursday, January 06, 2011 12:40 PM
To: Weems, Joyce
Cc: Histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Billing question

Hey Joyce,

My understanding has always been that if the pathologist specifically
mentions the stain in the report, then it's OK to charge all the fees.
However, if the pathologist chooses to leave any mention of the stain/immuno
in the report, then you can't bill for it.  So if the pathologist mentions a
specific stain was done, but that the findings were negative, you can still
charge.  In the case of an exhausted tumor, I think the ultimate discretion
comes to whether or not the pathologist chooses to mention it in the
report.  That's just from my experience, but I would love to hear how others
are handling instances such as these, too!

Drew

On Thu, Jan 6, 2011 at 12:22, Weems, Joyce  wrote:

> When you have performed a special stain or immuno that does not help the
> pathologist (tumor exhausted, etc) do you still charge for the technical
> component and the pathologist credits the professional fee? Just curious..
>
> Happy New Year, Everyone!
>
> Thanks! j
>
>
> Joyce Weems
> Pathology Manager
> Saint Joseph's Hospital
> 5665 Peachtree Dunwoody Rd NE
> Atlanta, GA 30342
> 678-843-7376 - Phone
> 678-843-7831 - Fax
>
>
> Confidentiality Notice:
> This e-mail, including any attachments is the
> property of Catholic Health East and is intended
> for the sole use of the intended recipient(s).
> It may contain information that is privileged and
> confidential.  Any unauthorized review, use,
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Re: [Histonet] Billing question

[Drew Meyer]

Hey Joyce,

My understanding has always been that if the pathologist specifically
mentions the stain in the report, then it's OK to charge all the fees.
However, if the pathologist chooses to leave any mention of the stain/immuno
in the report, then you can't bill for it.  So if the pathologist mentions a
specific stain was done, but that the findings were negative, you can still
charge.  In the case of an exhausted tumor, I think the ultimate discretion
comes to whether or not the pathologist chooses to mention it in the
report.  That's just from my experience, but I would love to hear how others
are handling instances such as these, too!

Drew

On Thu, Jan 6, 2011 at 12:22, Weems, Joyce  wrote:

> When you have performed a special stain or immuno that does not help the
> pathologist (tumor exhausted, etc) do you still charge for the technical
> component and the pathologist credits the professional fee? Just curious..
>
> Happy New Year, Everyone!
>
> Thanks! j
>
>
> Joyce Weems
> Pathology Manager
> Saint Joseph's Hospital
> 5665 Peachtree Dunwoody Rd NE
> Atlanta, GA 30342
> 678-843-7376 - Phone
> 678-843-7831 - Fax
>
>
> Confidentiality Notice:
> This e-mail, including any attachments is the
> property of Catholic Health East and is intended
> for the sole use of the intended recipient(s).
> It may contain information that is privileged and
> confidential.  Any unauthorized review, use,
> disclosure, or distribution is prohibited. If you are
> not the intended recipient, please delete this message, and
> reply to the sender regarding the error in a separate email.
>
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[Histonet] Billing question

[Weems, Joyce]

When you have performed a special stain or immuno that does not help the 
pathologist (tumor exhausted, etc) do you still charge for the technical 
component and the pathologist credits the professional fee? Just curious..

Happy New Year, Everyone!

Thanks! j


Joyce Weems
Pathology Manager
Saint Joseph's Hospital
5665 Peachtree Dunwoody Rd NE
Atlanta, GA 30342
678-843-7376 - Phone
678-843-7831 - Fax


Confidentiality Notice:
This e-mail, including any attachments is the 
property of Catholic Health East and is intended 
for the sole use of the intended recipient(s).  
It may contain information that is privileged and 
confidential.  Any unauthorized review, use,
disclosure, or distribution is prohibited. If you are 
not the intended recipient, please delete this message, and 
reply to the sender regarding the error in a separate email. 
 
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Re: [Histonet] billing for breast cases

[DKBoyd]

My understanding is:  Inked margins (on any specimen type) are 88307. 
Doesn't specify who inks the margin.

Debbie M. Boyd, HT(ASCP) l Chief Histologist l Southside Regional Medical 
Center I 
200 Medical Park Boulevard l Petersburg, Va.  23805 l T: 804-765-5050 l F: 
804-765-5582 l dkb...@chs.net







"Hutton, Allison"  
Sent by: histonet-boun...@lists.utsouthwestern.edu
12/29/2010 12:35 PM

To

cc

Subject
[Histonet] billing for breast cases






A debate has arisen and I am looking to histonet for a more definitive 
answer.  We have a breast surgeon who, after he removes the lumpectomy 
specimen, always goes back and removes more tissue around the margins of 
the lumpectomy.  Our question is how should these additional margins be 
charged.  Currently we charge an 88305 for each of the additional margins 
(there are no sutures indicating any orientation, however, one can 
determine the old and new margins).  Is 88305 the correct charge in this 
situation or should they be higher at an 88307?
Thank you in advance,
Allison
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[Histonet] billing for breast cases

[Hutton, Allison]

A debate has arisen and I am looking to histonet for a more definitive answer.  
We have a breast surgeon who, after he removes the lumpectomy specimen, always 
goes back and removes more tissue around the margins of the lumpectomy.  Our 
question is how should these additional margins be charged.  Currently we 
charge an 88305 for each of the additional margins (there are no sutures 
indicating any orientation, however, one can determine the old and new 
margins).  Is 88305 the correct charge in this situation or should they be 
higher at an 88307?
Thank you in advance,
Allison
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[Histonet] billing consults

[Tench, Bill]

we ask the consultant to bill the patient's insurance.  If they don't do
that, they bill the hospital and the hospital passes the charges on to
the patient.  we do not make any distinction based on where the request
for the consultation came from (us, the patient, the treating
clinician).  The patient is the beneficiary of the service.  On the very
rare case when it clearly is an issue of intellectual curiosity (i can
think of only 3 examples), the practice will pay the charge.
 
Bill Tench
Associate Dir. Laboratory Services
Chief, Cytology Services
Palomar Medical Center
555 E. Valley Parkway
Escondido, California  92025
bill.te...@pph.org
Voice: 760- 739-3037
Fax: 760-739-2604
 

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RE: [Histonet] BILLING QUESTION

[Feher, Stephen]

You can contract for services to another lab or hospital and depending
upon the terms of the contract, you may be able to bill the patient.
For example, you send all of your HER2's and ER/PR to another lab to be
stained and quantified into a score.  You may contract with the other
lab for them to charge you a flat fee for the service and you will bill
the patient for 88361x3.  

The other side is that you can contract for the other hospital to do the
test, bill the patient and your hospital pays no fee but misses out on
some of the compensation. 


Steve

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cynthia
Pyse
Sent: Friday, July 02, 2010 1:52 PM
To: 'Sara Baldwin/mhhcc.org'; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] BILLING QUESTION

We have a contract with the hospitals, this comes from our billing
manger.
We bill the hospitals, then they bill the patient. 

Cindy Pyse, CLT, HT (ASCP)
Histology Supervisor
X-Cell Laboratories
e-mail cp...@x-celllab.com



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sara
Baldwin/mhhcc.org
Sent: Friday, July 02, 2010 11:59 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] BILLING QUESTION

Histonetters:
If you do some work for another hospital (Histology) can you bill the
hospital or do you have to bill the patient directly?  Is there a
statute or Regulation out there about this?

Thanks
Pathology Supervisor
Kathy Baldwin, SCT (ASCP)
Memorial Hospital and Health Care Center sbald...@mhhcc.org Ph
812-482-0210, 482-0216,  Fax 812-482-0232, Pager 812-481-0897
Confidential information, Authorized use only.

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RE: [Histonet] BILLING QUESTION

[Cynthia Pyse]

We have a contract with the hospitals, this comes from our billing manger.
We bill the hospitals, then they bill the patient. 

Cindy Pyse, CLT, HT (ASCP)
Histology Supervisor
X-Cell Laboratories
e-mail cp...@x-celllab.com



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sara
Baldwin/mhhcc.org
Sent: Friday, July 02, 2010 11:59 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] BILLING QUESTION

Histonetters:
If you do some work for another hospital (Histology) can you bill the
hospital or do you have to bill the patient directly?  Is there a statute or
Regulation out there about this?

Thanks
Pathology Supervisor
Kathy Baldwin, SCT (ASCP)
Memorial Hospital and Health Care Center
sbald...@mhhcc.org
Ph 812-482-0210, 482-0216,  Fax 812-482-0232, 
Pager 812-481-0897
Confidential information, Authorized use only.

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[Histonet] BILLING QUESTION

[Sara Baldwin/mhhcc.org]

Histonetters:
If you do some work for another hospital (Histology) can you bill the hospital 
or do you have to bill the patient directly?  Is there a statute or Regulation 
out there about this?

Thanks
Pathology Supervisor
Kathy Baldwin, SCT (ASCP)
Memorial Hospital and Health Care Center
sbald...@mhhcc.org
Ph 812-482-0210, 482-0216,  Fax 812-482-0232, 
Pager 812-481-0897
Confidential information, Authorized use only.

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RE: [Histonet] Billing for Prostate Biopsies

[Lester Raff MD]

Each separately submitted jar with a specified location is coded as
88305, regardless of the number of cores in the jar. An exception is for
"saturation" biopsies (ultrasound guided template needle biopsies) that
are coded using 4 specific G codes, depending on total number of cores.

Lester J. Raff, MD
Medical Director
UroPartners Laboratory
2225 Enterprise Dr. Suite 2511
Westchester, Il 60154
Tel 708.486.0076
Fax 708.486.0080
-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Parker,
Helayne
Sent: Thursday, April 29, 2010 3:06 PM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] Billing for Prostate Biopsies

Can anyone tell me what/how prst bx are billed ??

Helayne Parker, HT (A.S.C.P.)
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[Histonet] Billing for Prostate Biopsies

[Parker, Helayne]

Can anyone tell me what/how prst bx are billed ??

Helayne Parker, HT (A.S.C.P.)
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Re: [Histonet] Billing for H&E stains

[DKBoyd]

I've never done a H&E on cytology just a Pap stain and Diff Quik.  The 
stain charge, however is determined by the preparation technique (a smear 
or cytospin concentration preparation).  The cytospin prep (Non Gyn) is 
88108:   the smear (NonGyn) is 88104.

Debbie M. Boyd, HT(ASCP) l Chief Histologist l Southside Regional Medical 
Center I 
200 Medical Park Boulevard l Petersburg, Va.  23805 l T: 804-765-5050 l F: 
804-765-5582 l dkb...@chs.net







awe...@shorememorial.org 
Sent by: histonet-boun...@lists.utsouthwestern.edu
03/02/2010 10:45 AM

To
histonet@lists.utsouthwestern.edu
cc

Subject
[Histonet] Billing for H&E stains







Good Morning
Anyone out there doing H&E on cytology slides?  Currently I am trying to 
do
H&E stains on our FNA's, is there a separate charge for  billing the H&E
per slide?


Andrea J Weiss BST CT (ASCP)
Cytotechnologist
609 653 3577 Ext 4907
awe...@shorememorial.org


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[Histonet] Billing for H&E stains

[AWeiss]

Good Morning
Anyone out there doing H&E on cytology slides?  Currently I am trying to do
H&E stains on our FNA's, is there a separate charge for  billing the H&E
per slide?


Andrea J Weiss BST CT (ASCP)
Cytotechnologist
609 653 3577 Ext 4907
awe...@shorememorial.org


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contact the sender and destroy all copies of the transmittal.


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RE: [Histonet] Billing code for kidney core adequacy

[Smith Wanda]

We use 88329 Pathology consultation during surgery. 


WANDA G. SMITH, HTL(ASCP)HT
Pathology Supervisor
TRIDENT MEDICAL CENTER
9330 Medical Plaza Drive
Charleston, SC  29406
843-847-4586
843-847-4296 fax

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-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Kathleen Boozer
Sent: Friday, February 05, 2010 4:43 PM
To: Histonet
Subject: [Histonet] Billing code for kidney core adequacy

Could someone please clarify the correct billing CPT codes for a pathologist 
who looks at a kidney biopsy for adequacy before being sent off to referral for 
EM, IF and LM.  We were using 88172 but are now being told to use 88333 and 
88334.  

Thank you,

Kathy Boozer, HT (ASCP), IHCQ
Adventist Medical Center
10123 SE Market St.
Portland, OR  97216
booze...@ah.org

 



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[Histonet] Billing code for kidney core adequacy

[Kathleen Boozer]

Could someone please clarify the correct billing CPT codes for a pathologist 
who looks at a kidney biopsy for adequacy before being sent off to referral for 
EM, IF and LM.  We were using 88172 but are now being told to use 88333 and 
88334.  

Thank you,

Kathy Boozer, HT (ASCP), IHCQ
Adventist Medical Center
10123 SE Market St.
Portland, OR  97216
booze...@ah.org

 



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[Histonet] Billing question

[Lecorchick, William]

Is anyone aware of a CPT code for a Tech assisted bone marrow aspiration and 
biopsy?  From time to time we have been helping the Oncologist and Radiologist 
on these procedures. It is becoming more of a common practice and we spend 
anywhere from a ½ hour to 1 ½ hours and not billing for our services. Is there 
anyone else in a similar situation?
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Re: [Histonet] Billing question

[Michael LaFriniere]

It is my understand that , Yes you can bill as long as the  ASR
disclaimer is on the report and you heave validation of such antibodies
that do did not have FDA approvals yet
 
Michael LaFriniere

>>> On 12/9/2008 at 12:53:16 PM, Rene J Buesa <[EMAIL PROTECTED]>
wrote:
As your pathologists first because even when we charged for IHC to the
patients, there was always a disclaimer saying that the Ab was for
research, in spite of which, the charges were done (they are essentially
for the pathologist interpretation).Hope this will help you.
René J.

--- On Tue, 12/9/08, KELLY BOYD <[EMAIL PROTECTED]> wrote:

From: KELLY BOYD <[EMAIL PROTECTED]>
Subject: [Histonet] Billing question
To: "histonet" 
Date: Tuesday, December 9, 2008, 12:15 PM

Hi all!

Question for those familiar with all the billing regulations: If you
use an
antibody that is for RUO (research use only) or ASR (analyte specific
reagent),
can you bill the patient for these immunos?


Kelly D. Boyd, BS, HTL (ASCP)
Lab Manager
Harris Histology Services
2025 Eastgate Dr. Ste. F
Greenville, NC 27858
www.harrishisto.com 

Tele (252)-830-6866
Cell  (252)-943-9527
Fax  (252)-830-0032





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Re: [Histonet] Billing question

[Rene J Buesa]

As your pathologists first because even when we charged for IHC to the 
patients, there was always a disclaimer saying that the Ab was for research, in 
spite of which, the charges were done (they are essentially for the pathologist 
interpretation).Hope this will help you.
René J.

--- On Tue, 12/9/08, KELLY BOYD <[EMAIL PROTECTED]> wrote:

From: KELLY BOYD <[EMAIL PROTECTED]>
Subject: [Histonet] Billing question
To: "histonet" 
Date: Tuesday, December 9, 2008, 12:15 PM

Hi all!
 
Question for those familiar with all the billing regulations: If you use an
antibody that is for RUO (research use only) or ASR (analyte specific reagent),
can you bill the patient for these immunos?


Kelly D. Boyd, BS, HTL (ASCP)
Lab Manager
Harris Histology Services
2025 Eastgate Dr. Ste. F
Greenville, NC 27858
www.harrishisto.com 
 
Tele (252)-830-6866
Cell  (252)-943-9527
Fax  (252)-830-0032
 
 



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RE: [Histonet] Billing question

[Weems, Joyce]

If I understand correctly...

RUO - No
ASR - Yes with a disclaimer

Joyce


 

-Original Message-
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of KELLY BOYD
Sent: Tuesday, December 09, 2008 12:16 PM
To: histonet
Subject: [Histonet] Billing question

Hi all!
 
Question for those familiar with all the billing regulations: If you use an 
antibody that is for RUO (research use only) or ASR (analyte specific reagent), 
can you bill the patient for these immunos?


Kelly D. Boyd, BS, HTL (ASCP)
Lab Manager
Harris Histology Services
2025 Eastgate Dr. Ste. F
Greenville, NC 27858
www.harrishisto.com 
 
Tele (252)-830-6866
Cell  (252)-943-9527
Fax  (252)-830-0032
 
 


  
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[Histonet] Billing question

[KELLY BOYD]

Hi all!
 
Question for those familiar with all the billing regulations: If you use an 
antibody that is for RUO (research use only) or ASR (analyte specific reagent), 
can you bill the patient for these immunos?


Kelly D. Boyd, BS, HTL (ASCP)
Lab Manager
Harris Histology Services
2025 Eastgate Dr. Ste. F
Greenville, NC 27858
www.harrishisto.com 
 
Tele (252)-830-6866
Cell  (252)-943-9527
Fax  (252)-830-0032
 
 



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