I'd be grateful to hear from anyone who considers themselves knowledgeable about CPT coding in regards to the following:

Our billing dept is kicking back bills on cytology samples that have had special stains performed BECAUSE the CPT code book description for special stains (88312 and 88313) reads as follows:

 

"special stains (list separately in addition to code for surgical pathology examination), Group I (or II)"

 

there is no mention of cytology samples in the descriptive for special stains, only surgical pathology, which implies that stains cannot be billed on cytology samples. There are no separate codes for special stains performed on cytology samples.

 

We had a bronchoscopy specimen on an immunosuppressed patient stained for AFB and Fungus kicked back. By the way, it was not kicked back by the insurance co. our billing department has it's own software to clean up bills to reduce the number of rejected claims.

 

Is the use of stains on cytology samples not the standard of care and do you know if you are getting paid for doing them?

 

thanks

 

 

 

Vinnie Della Speranza
Manager for Anatomic Pathology Services
Medical University of South Carolina
165 Ashley Avenue  Suite 309
Charleston, SC 29425
Ph: 843-792-6353
fax: 843-792-8974