[Histonet] another point on billing codes

Weems, Joyce JWEEMS <@t> sjha.org
Wed Aug 29 08:07:58 CDT 2007


This is the first that I have heard that the code for IHC might be based on negative or positive results. I believe the code addresses the stain not the results.... my 2 cents. j:>)

Joyce Weems
Pathology Manager
Saint Joseph's Hospital 
5665 Peachtree Dunwoody Rd NE
Atlanta, GA 30342
404-851-7376 - Phone
404-851-7831 - Fax


-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu]On Behalf Of Orr,
Rebecca
Sent: Wednesday, August 29, 2007 7:25 AM
To: histonet <@t> lists.utsouthwestern.edu
Cc: IHCRG Resource Group (E-mail)
Subject: [Histonet] another point on billing codes


Helayne,
I'm interested in everyone's input on this thread.
Charging for Breast cases seems to be as unclear as the processing
guidelines.
We are now in the process of figuring out charges if the ER PR Her2
results are negative.

ER PR Her2 are quantitative (2+, 3+) or semi quantitative (weakly or
strongly positive, etc)
Assuming these markers are ordered on a breast cancer (not a benign
breast), even a negative result is quantitative and contributes to the
outcome of the therapy., isn't this right?  
Please steer me in the right direction if this is an incorrect point.

So we are being told by our billing folks that we must change the code
on the negative resulted ER PR her2 to a lesser charge.
I can understand if CPT may think doctors are charging on unnecessary
IHC tests, but they are focusing on the wrong tests.
(in my opinion).
A negative or 0  result on these particular markers should NOT be
synonymous with "

Quite perplexing and frustrating. 


---Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu]On Behalf Of Parker,
> Helayne
> Sent: Tuesday, August 28, 2007 4:25 PM
> To: histonet <@t> lists.utsouthwestern.edu
> Subject: [Histonet] CPT codes
>
>
> Hi all,
>  Does anyone know the correct charges to charge a breast lump that
must
> be inked.  Someone told us we could only charge a -307 if it has
cancer
> in the micro margins.  As much gross work is done either way (cancer
or
> not) so what is the real truth ?  We have given most lumps 305 and I
am
> thinking we are undercharging.
>
> Thanks,
> Helayne Parker, HT (ASCP)
> Histology Section Head
> Skaggs Community Health Center
> Branson, Missouri
Becky Orr CLA,HT(ASCP)QIHC
Anatomic Pathology
Evanston Northwestern Healthcare
847-570-2771
 


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