Pathology/Lab Coding Alert

Question: Our Medicare payer tells us that we cannot bill for 88184 with G0265 when our lab processes stem cells for transplantation. Is this a concern only for our local fiscal intermediary, or is this a national issue?


Florida Subscriber

Answer: A National Correct Coding Initiative edit prohibits reporting G0265 (Cryopreservation, freezing and storage of cells for therapeutic use, each cell line) with any of the flow cytometry codes, including 88184 (Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker). NCCI is a national policy, not a local one, and that's why your Medicare payer won't pay for both G0265 and 88184.

Routine cryopreservation and storage techniques for therapeutic transfusion can damage the cells, and labs often use flow cytometry as a quality check to assess cell viability. You don't state the reason that your lab performs the G0265 and flow cytometry services together, but presumably it is for this quality-monitoring purpose. Medicare will not pay separately for the flow cytometry (88184) with the therapeutic transplant service (G0265).

Remember that G0265 is Medicare's code for cryopreservation of cells only for therapeutic transplant purposes. If your lab performs cryopreservation of cells for diagnostic purposes, you should report 88240 (Cryopreservation, freezing and storage of cells, each cell line).

Reader Questions and You Be the Coder were prepared with the assistance of R.M. Stainton Jr., MD, president of Doctors' Anatomic Pathology Services in Jonesboro, Ark.