[Histonet] Re: CPT coding during accession

[Robert Richmond]

Tere Hodges at St. Mary's Hospital in Tucson, Arizona asks:

>>When you put in charges as a preliminary charge ... do you over bill or under bill? I have always stayed under while putting in charges and then audit the doctor's charges the next day. Example:
colon segment other then tumor... bill   88307
the next day tumor was found now it is bumped up to 88309<<

In my experience in a number of institutions, doing the CPT coding
when you accession the specimen is a bad idea - most of the coding
errors never get caught. CPT coding should be done at sign-out or
afterward. Remember that a number of common skin lesions are 88304
rather than 88305 depending on the microscopic diagnosis, and that
coding a hysterectomy specimen is a dark art that I don't like to make
anybody else take responsibility for (except maybe Harry Potter, who
after all can cast a patronus charm).

I think the responsible pathologist should do the coding (this is a
common practice, but not common enough), and that somebody else (like
you) should check the pathologist's coding to make sure that nothing
has been omitted (decalcification, the routine special stain that was
useless in a particular case).

Bob Richmond
Samurai Pathologist
Knoxville TN