Pathology/Lab Coding Alert

Question: When our pathologists receive a request to examine old specimens, what should we use as the date of service? Using the original date of the specimen would often place us outside of filing limits, and we won't be paid.


Michigan Subscriber

Answer: Medicare's policy, implemented in Change Request 4156 dated Dec. 30, 2005, clarifies rules for selecting date of service (DOS). Many insurers use a similar policy. Under this policy, the answer to your question depends on how old the specimen is. If the original specimen-collection date is, at most, 30 calendar days ago, you should use that as the DOS.

If the specimen was stored for more than 30 calendar days, you should list the DOS as the date that you took the specimen from storage. Medicare defines a specimen stored more than 30 days as "archived," and specifies that this is the only exception in which you should not use the original specimen-collection date as the DOS.

For instance: On March 9, 2006, a physician requests a HER-2/neu test on a breast tissue specimen stored since Jan. 15, 2004. You should report the service as 88367 (Morphometric analysis, in situ hybridization [quantitative or semi-quantitative], each probe; using computer-assisted technology) or 88368 (... manual) depending on the lab method. Use March 9, 2006, as the date of service for the test.