[Histonet] another point on billing codes

Joe Nocito jnocito <@t> satx.rr.com
Wed Aug 29 08:24:51 CDT 2007

I'm not a pro (but I do play one on TV) but I checked billing at my old lab 
for 6 years. An immuno is an immuno is an immuno regardless of antibody 
and/or result.  ER/PR, Her2 all have a diagnostic value whether  + or -. 
They need to be charged. If you run a pan-CK, S100, Vimentin and a CD-45 
(LCA) and the LCA is positive, do you still charge for the cytokeratin and 
S100? Of course you do.
    If you find yourself battling your billing dept. every time, do what I 
did. I gave them a copy of the report to show them what was going on. After 
a while, they stopped questioning me. As a matter of fact (and I know this 
is hard to believe for some of you) we became close. They were the ones who 
wanted a luncheon for me when I left.
    Thanks, my 4 cents and I hope I helped instead of causing more trouble.


----- Original Message ----- 
From: "Orr, Rebecca" <ROrr <@t> enh.org>
To: <histonet <@t> lists.utsouthwestern.edu>
Cc: "IHCRG Resource Group (E-mail)" <ihcrg <@t> googlegroups.com>
Sent: Wednesday, August 29, 2007 6:24 AM
Subject: [Histonet] another point on billing codes

I'm interested in everyone's input on this thread.
Charging for Breast cases seems to be as unclear as the processing
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
> be inked.  Someone told us we could only charge a -307 if it has
> in the micro margins.  As much gross work is done either way (cancer
> not) so what is the real truth ?  We have given most lumps 305 and I
> thinking we are undercharging.
> Thanks,
> Helayne Parker, HT (ASCP)
> Histology Section Head
> Skaggs Community Health Center
> Branson, Missouri
Anatomic Pathology
Evanston Northwestern Healthcare

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