Oncology & Hematology Coding Alert

Question: We have a part-time cytotechnologist on staff who interprets some of our Medicare screening tests when the physicians get too busy seeing patients. Last week, a patient reported for a screening cytopathology; the oncologist performed the screening, and the technologist interpreted the results. How should I code this scenario, and should it be coded differently if the oncologist also interpreted the results?

Kansas Subscriber

Answer: Who interpreted the test results makes a big difference when reporting a screening cytopathology to Medicare. When you submit a claim to Medicare for the screening, you must know who reviewed the test results: the cytotech or the oncologist.
 
In the scenario you describe, in which the oncologist performed the cytopathology screening and the cytotechnician interpreted results, you should report G0123 (Screening cytopathology, cervical or vaginal [any reporting system], collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision) for the service.
 
Exception: If the oncologist performs the cytopathology screening and interprets the results, you should report G0124 (Screening cytopathology, cervical or vaginal [any reporting systems], collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician) for the service.
 
Be careful when using G0123 and G0124. The code descriptors differ by just a few words - but Medicare will surely notice if you report the wrong one.