Oncology & Hematology Coding Alert

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 [...]