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Pathology/Lab Coding Alert

CCI Policy Manual:

G0416-G0419: Mark 5 Prostate Biopsies as the Magic Cutoff For 88305

Published on Mon Apr 09, 2012

Method, not number, should lead code choice. Quarterly updates aren't the only way that Medicare's Correct Coding Initiative (CCI) provides guidance for your lab. If you overlook changes to the National Correct Coding Initiative Policy Manual, you could miss important restrictions -- such as how to report prostate biopsies -- that impact your laboratory compliance. Background: Each year, CMS updates the Policy Manual, which offers rationales for various CCI edits, as well as establishing compliance and coverage policies you must heed. A Jan. 2012 update provides several changes that you've read about in Pathology/Lab Coding Alert articles such as "83704: Look for NMR Lipoprotein Limits and Opportunities" in Vol. 13 no 3. Tweak Prostate Saturation Biopsy Rules Although the latest Policy Manual lists "5" as the strict number cutoff for choosing your prostate saturation biopsy code, the number is not the only thing you need to take into account. First thing: Before [...]
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