[Histonet] Skin billing

[Terri Braud]

Our institution follows the CPT coding and associated billing, just as you explained. For those surgeries done within our facilities, there is a specific list of specimens which must be submitted.  This was agreed upon by med staff and is listed in the bylaws, in response to the following CAP question:
ANP.10032	Surgical Pathology Microscopic Exemptions	Phase I
There is a policy regarding what types of surgical specimens (if any) may be exempt from microscopic examination.
NOTE: Irrespective of any exemptions, microscopic examination should be performed whenever there is a request by the submitting or attending physician, or at the discretion of the pathologist when indicated by the clinical history or gross findings.  If there is such a policy, it should be approved by the medical staff or appropriate committee.  Typical exempt specimens include foreskins in children, prosthetic cardiac valves without attached tissue, torn meniscus, varicose veins, tonsils in children below a certain age, etc.
As far as physician's offices and the rules that regulate them, I don't know. Generally, the 88302 and 88304 are lesser charges anyway. I hope this helps. 
Sincerely, Terri
Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
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Message: 2
Date: Tue, 8 Mar 2016 22:07:45 +0000
From: "Vickroy, James" <jvickroy at SpringfieldClinic.com>
Subject: [Histonet] Billing for skin biopsies
There was a question today that I felt pretty comfortable answering but still thought I would see what others have found out on this subject.   Dermatologists are always asking if there is a lesser pathology charge for a skin lesion removed for cosmetic purposes.   My understanding is that while a clinician can charge less for removing something for cosmetic purposes once it goes to the pathology lab the charges are based on diagnosis and therefore the accepted CPT codes are generally 88302 ( plastic repair), 88304 (cyst debridement, skin tag) and 88305 for (other than the cyst, debridement, skin tag, or plastic repair).   And.............we can't charge differently just because it was removed for cosmetic purposes.    Please let me know your thoughts on this and if things are done differently at your institution.
I have told a clinician that they might not have to submit the "cosmetic" skin biopsy for pathology however I also don't believe that is a good idea either.
Jim
Jim Vickroy
Histology Manager
Springfield Clinic, Main Campus, East Building
1025 South 6th Street
Springfield, Illinois  62703
Office:  217-528-7541, Ext. 15121
Email:  jvickroy at SpringfieldClinic.com<mailto:jvickroy at SpringfieldClinic.com>
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