Pathology/Lab Coding Alert

Question: When our pathologist/hematologist consults for a difficult blood cross match, including examining and giving direction for patient care, how should we code the service? Can we report an E/M code?

Iowa Subscriber

Answer: You should code the pathologist's service as 86077 (Blood bank physician services; difficult cross match and/or evaluation of irregular antibody[s], interpretation and written report).

You should not code an evaluation and management (E/M) service in addition to 86077. Correct Coding Initiative (CCI) edits bundle 86077 with most E/M codes in the 99201-99354 range. The physician might provide services such as examining the patient, writing progress notes, and giving clinical orders for care such as fluid replacement. CMS considers these services bundled with 86077, however. Check with other payers for their rules.