# coding from path report



## coder in mo (Jul 24, 2008)

What is everyone's opinion on coding from a path report before pt is seen by doctor??  I don't agree with this, just wondering how everyone else feels.


----------



## kevbshields (Jul 24, 2008)

The pathologist is a doctor.


----------



## coder in mo (Jul 24, 2008)

Ok, let me rephrase that, I know that a pathologist is a dr., how about they are seen before the dr. you work for sees the patient?


----------



## mbort (Jul 24, 2008)

How could you be coding from the pathology report if your physician hasnt see the patient yet?  Could you post the entire scenario in order for members to better assist you?


----------



## coder in mo (Jul 24, 2008)

That's exactly my point, they are wanting to change to me coding from the path report before the pt is even being seen by our dr.'s, I'm trying to tell them I don't feel comfortable doing that, so I'm trying to get other people's opinions to help prove my point.


----------



## mbort (Jul 24, 2008)

the only thing you would be pulling from a pathology report would be a diagnosis.  Are they wanting you to code/bill for an E/M visit before the doc sees the patient using a dx from the pathology report?


----------



## racheleporterwilliams (Jul 24, 2008)

WORD TO THE WISE: no matter what the scenario is, instead of saying you 'don't feel comfortable' (because employers don't care about their employees feelings and someone's feelings are not contractual[if you are in a union environment]), quote guidelines and compliance regulations with proof in a very tactful way....if then your employer insists you follow their directive, then code according to their specifications....just keep a personal log-at home-of the scenario and keep it pushing....don't keep pt's files just the pertinent info...if it becomes an adversarial environment, then look for employment elsewhere
also, I would advise you to get insurance if you don't already have it-there's a great discount from the AAPC...look under member benefits for more info
GOOD LUCK!!!!!!



coder in mo said:


> That's exactly my point, they are wanting to change to me coding from the path report before the pt is even being seen by our dr.'s, I'm trying to tell them I don't feel comfortable doing that, so I'm trying to get other people's opinions to help prove my point.


----------



## jas0426 (Jul 31, 2008)

I merely use the path report as an additional source to get any information that might be lacking in the op note, that is necessary for coding.


----------



## dclark7 (Aug 1, 2008)

I don't understand what they want you to code.  If your doctor did the surgery you can certainly use the path report to help with the diagnosis coding, however any follow-up would be in the global period. It would help to know what type of doctor you work for and why he/she is seeing the patient.


----------



## dmaec (Aug 1, 2008)

I'm with dclark7 on this - I don't understand the question.  How can you have a path report if the patient hasn't been seen yet?  Who ordered (or did) whatever was sent to pathology for findings? (some other provider?)..  What are you coding, the path report itself, pathology findings?  You can certainly code that if you're coding pathology.  (I've coded tons of pathology, profee side only -I had to append the modifier .26 to the codes if needed).  For our providers who send stuff to path, we usually will hold the claim until the results come in and code accordingly.  The patients are always seen by the provider first, because how else would they get the sample to send to pathology?  OR, is your doctor a specialist, and the patient has been sent to them for consult due to whatever came back on a path report from another provider?  Could you rephrase your question again?  A bit more specific.


----------



## FTessaBartels (Aug 5, 2008)

*Let's see if we can clarify*

Okay, let's try this scenario (I am making this up, but coder-in-mo please let us know if this fits your circumstance)

Patient undergoes biopsy by Doctor A; specimen sent to path.
Patient referred to specialist - Doctor B - for treatment after path report comes in.
Coder-in-mo is trying to code for Doctor B; the path report precedes any visit at all with Doctor B.

Now, coder-in-mo ... what are you being told to code from the path report ... diagnosis? (why isn't your doctor stating dx in his documentation?) ... are you needing to code to get pre-auth for additional procedure/visit?  

If you can more clearly outline the scenario, we might be able to give you an answer to your question.

F Tessa Bartels, CPC, CPC-E/M


----------

