Advanced Search

Oncology & Hematology Coding Alert

Reader Questions:

Let Lab Report Lab Code

Published on Tue May 25, 2010

Question: Our oncologist wants to report 85097 when he takes a bone biopsy, looks at the sample, prepares a brief report, and then sends the sample to pathology. In this situation, should I report 85097 for the oncologist's services?Oklahoma SubscriberAnswer: No. If both the oncologist and the lab report the same code for the same service, the payer will pay only one. In the case you describe, the lab that provides the formal evaluation and report should submit the lab service code. Because the oncologist performed the "bone biopsy," as you describe it, the oncologist should submit a claim for that service.Service check: Verify the precise service your oncologist performed before submitting your claim: bone marrow aspiration, bone marrow biopsy, or bone biopsy. Your question refers to 85097 (Bone marrow, smear interpretation), which is the lab code for pathology exam of a bone marrow aspiration -- not biopsy. If the oncologist [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Oncology & Hematology Coding Alert

View All