[Histonet] problem with 88305 reimbursement

Jesus Ellin JEllin <@t> yumaregional.org
Tue Jan 29 15:48:13 CST 2013

How is this if the biopsy procedure is being done at the physician's facility?  I have heard though this is just the start of including the biopsy within the DRG if it comes back with positive for cancer,, but once again this is a hear say.  This is also to include any testing for IHC, ISH, or molecular testing.

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Cynthia Pyse
Sent: Tuesday, January 29, 2013 11:51 AM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] problem with 88305 reimbursement

Hi Histonetters

We are currently having a problem with our Medicare reimbursement on the tech component of the 88305. If the patient has been seen at a hospital, either in-patient or out- patient, we are told by Medicare that we have to contract with that hospital to bill for the 88305. The biopsy was not done at the hospital but in a doctor's office. According to Medicare if there the same date of service it can only be billed through the hospital. Medicare is calling it consolidated billing. I can't see how the hospital can bill for something that was done in the doctor's office then sent to an independent lab. Is anyone else having this problem? How are you handling it with Medicare? Any help would be appreciated. Thanks in advance




Cindy Pyse, CLT, HT (ASCP)

Laboratory Manager

X-Cell Laboratories

20 Northpointe Parkway Suite 100

Amherst, NY 14228

716-250-9235 etx. 232

e-mail cpyse <@t> x-celllab.com


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