[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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