RE: CPT coding/billing

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From:"Jennings-Siena, Debbie" <>
To:"'Tapper, Sheila'" <>
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Hi Sheila,
If all six lesions are separately submitted and separately identified and
diagnosed separately then all 6 may be charged for. All are to be mentioned
separately in the pathology report, However, if all six are in the same
container and not designated by size, shape, nick, suture or some other
definate way to distinguish them, they must be counted as one specimen.  The
CPT (Current Procedural Terminology) coding system from the AMA (American
Medical Association) is what most people use to charge specimens by and must
be used for charging Medicare cases.  The codes are chosen according to type
of specimen.  The codes 88300-88309 are followed by specimen types.   For
example on skin- 88304 is the CPT code for skin-cyst/tag/debridement and
88305 is the code for skin, Other than cyst/tag/debridement/plastic repair.
As far as modifiers go- if you are only billing the technical component
(processing, cutting, and staining) then the modifier -TC is added and the
pathologist who bills the professional part (reading the slides) would add a
-26 modifier to the above mentioned codes.  I hope this is helpful, if you
have other questions, please do not hesitate to let me know.  

Debbie Jennings-Siena
NSH Legislative Chairperson
Baylor University Medical Center
Dallas, TX 75246

-----Original Message-----
From: Tapper, Sheila []
Sent: Wednesday, February 02, 2000 8:50 PM
To: 'histonet'
Subject: CPT coding/billing

I am looking for some input!  How do your institutions handle multiple
specimens?  If the dermatologist removes 6 separate lesions, are all 6
specimens billed?  Are they billed at the same price?  Do you "cap" the
pricing at any time?  Do you use modifiers?  If you are using modifiers for
multiple specimens, which one do you use?   I would appreciate any and all

It is getting late here, I hope this makes sense!

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