Thursday 25 July 2013

CPT 2010: Gather Molecular studies preparation pay

When your pathologist carries out sterile macroscopic dissection to prep tissue for molecular diagnostics tests, you did not have a way to capture the service prior to this. Take advantage of this new payment opportunity by learning when you can and cannot use the 2010 codes, how to document the service and what you need to know for correct billing.

Tip 1: Know the ‘Macro' service

CPT 2010 introduces two new codes to describe surgical pathology tissue prep for some ancillary tests. These codes describe macroscopic examination and processing of the target tissue like a sentimental lymph node for non-microscopic molecular analysis.

The processing covers work like dissecting an appropriate portion of the tissue away from the main specimen and cutting and labeling thin sections under sterile conditions.

Tip 2: Apply codes to pre-analytic work

You shouldn't report 88387 or +88388 when the pathologist retrospectively chooses tissue block for molecular analysis based on the initial slide review.

You have to think ‘pre-analytic and ‘macroscopic' when deciding whether to use one of these codes. Early indications are that some labs are using them incorrectly if you are selecting tumor cells from paraffin embedded material or cutting sections from a block for send-out, that's not covered by 88387 or +88388.

Tip 3: Ban 88387-88388 for microbiology or flow cytometry prep

According to CPT 2010, you shouldn't go for 88387-88388 for tissue preparation for microbiologic cultures or flow cytometric studies.

That rules out reporting 88387 or +88388 as prep for any microbiology codes or 88182-88189.

Tip 4: Avoid 88387-88388 for Microscopy Prep

As the code descriptors specifically reference no-microscopic analytic studies, you shouldn't report 88387 or +88388 for tissue prep for special stains or immunohistochemistry-based tumor morphometry analysis.

Tip 5: Go for codes with ancillary molecular diagnostics

According to the code definition, you should go for 88387 or +88388 for special tissue prep for "nucleic-acid based molecular studies".

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