Pathology/Lab Coding Alert

Watch for new Mohs edits, too Coding principle: You can't bill for a primary-source infectious agent identification and a culture-method identification for the same test. That's the basis of four new edit pairs in Correct Coding Initiative (CCI) version 14.1, effective April 1.
 Exception: You might be able to override the edit pairs for distinct organisms. Let our experts show you when and how -quot; so you can capture every penny you deserve. Beware New CCI Edit Pairs CCI 14.1 bundles the following four codes with 87253 (Virus isolation; tissue culture, additional studies or definitive identification [e.g., hemabsorption, neutralization, immunofluorescence stain], each isolate):
- 87305 -quot; Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Aspergillus
- 87640 -quot; Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique
- 87641 -quot; - Staphylococcus aureus, methicillin resistant, amplified probe technique
- 87653 -quot; - Streptococcus, group B, amplified probe technique.  -These edit pairs add to a long list of CCI edits that restrict reporting primary-source infectious agent detection codes for a specific bacterial organism with culture identification codes or virus identification codes for the same specimen,- says William Dettwyler, MT-AMT, president of Codus Medicus, a laboratory coding consulting firm in Salem, Ore.
 Here's why: -The culture codes represent a different methodology and a different source, so you should never report those tests for the same specimen that your lab uses to identify an organism from a primary source,- Dettwyler says.
 Exception: -But if your lab isolates and definitively identifies a virus from tissue culture on the same day as one of the primary-source bacterial identifications, you-ll have to use modifier 59 (Distinct procedural service) to override these 87253 edit pairs,- he says. Micro Basics: Choose the Most Specific Identification  Keep in mind the following infectious-agent coding principles so you can understand and avoid the CCI pitfalls:
 When your lab identifies a specific infectious agent from a primary source, not a culture, you should select the most specific code from the range 87260-87899 based on the lab method and organism identified, Dettwyler says.
 For instance: If your lab identifies Chlamydia trachomatis using an amplified probe technique, you should report 87491 (Infectious agent detection by nucleic acid [DNA or RNA]; Chlamydia trachomatis, amplified probe technique).
 Be specific: You would select 87491 instead of the -generic- method code that does not specify the organism (87798, Infectious agent detection by nucleic acid [DNA or RNA], not otherwise specified; amplified probe technique, each organism).
 Similarly, you should select the organism code that matches the method your lab used, not another method, such as 87270 (Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis). Never report two different identification methods for the same organism, or you-re likely to face a CCI edit pair.
 Avoid [...]