RE: CPT coding

From:"Tague, Curtis"

The claim that medicare will only reimburse up to 4 charges per patient is a farce. We routinely get 12 to 16 PNB on a single patient. They have to be billed with a 59 modifier, ask your billing dpt about it.

Good luck.

 -----Original Message-----
From: 	Weems, Joyce [] 
Sent:	Monday, December 30, 2002 09:36
Subject:	RE: CPT coding

This seems strange. It is my understanding that a specimen is anything that
receives a separate diagnosis, no matter how matter specimens there are. j

Joyce Weems
Pathology Manager
Saint Joseph's Hospital of Atlanta
404-851-7831 - fax

 -----Original Message-----
From: 	Priscilla Delventhal [] 
Sent:	Sunday, December 29, 2002 8:05 AM
Subject:	CPT coding

I have been informed that medicare will not pay for more than 4 of the
same CPT codes on a patient per visit.  For instance more than 4
prostate biopsies will result in payment for only 4 biopsies even
though more than 4 were submitted.  The same with sampling more than 4
sites for colon bxs, etc.  I suppose this is to make these type of
procedures more uniform in cost, but it would seem like the wrong
people are being regulated as the anatomic pathology lab has to process
what is submitted by the surgeon.  Color coding the sites would bring
down the number of cassettes, but I find embedding more than 4-6 colon
bxs per cassette very tedious and time consuming.  Is this just a local
medicare ruling or is everyone dealing with this limitation?

Priscilla D. in Wyoming

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