[Histonet] Re: Is there a Pathology billing hotline?

[Bob Richmond]

Jennifer Johnson asks:

>>Today we received one container labelled 'sentinel nodes' for frozen
section. There were five nodes and they were placed in two chucks. How in
the heck are we to know how to code for charges for this?  Is it per
container, per node, or per frozen?  Plus, is there a person or agency that
you can call to ask these questions?<<

and Joyce Weems replies:

>>This would be one specimen, [if] the nodes were not separately
identified. You would charge an 88331 for the first block and 88332 for the
second block.<<

If the lymph nodes were separately identified, say, "sentinel node #1"
through "sentinel node #5" then if you separated them from each other (say
by marking them with different colored inks) then you could bill for five
specimens, five frozen section codes 88331 and five specimen codes 88305.
The final pathology report would have to identify them, say,
1. left axillary lymph node (sentinel node biopsy #1): Reactive
hyperplasia. No malignant tumor identified.
2. - and so on through 5.

Parenthetically, you shouldn't be doing frozen sections on grossly negative
sentinel lymph nodes - it loses too much tissue. Touch preparations suffice.

I don't know of any hot line for problems like this. Most of them are
covered in the CAP Web site resource on the subject, if you can find it.
It's quite chaotic, and it's worth reading it through and abstracting it on
a slow day. These adjudications - which unfortunately are no longer done -
are considered authoritative by the authorities. Here you read, for
example, that a twin placenta is two codes 88307 iff you can identify cord
A and cord B (doesn't matter how the identification is done).

Bob Richmond
Samurai Pathologist
Maryville TN