Pathology/Lab Coding Alert
Beware 'Noncontributory' Language
Question: Our pathologist examined three distinct cytology specimens and documented cell blocks for each specimen. However, the diagnosis section of the report designates two of the cell blocks as "noncontributory." Can we bill the technical and professional components of those tests anyway?
Answer: Yes, you can charge for the technical and professional components of the cell blocks that the pathologist evaluated and reported, even if the report states that they are "noncontributory." Report each cell block as 88305 (Level IV - Surgical pathology, gross and microscopic examination, Cell block, any source).
When the pathologist documents a stain or study that doesn’t result in clear diagnostic information, he might use the term "noncontributory," but there’s a better way. Because "noncontributory" might imply to an auditor that the procedure wasn’t medically necessary, it’s not a good word choice. For the same reason, you should avoid words like "routine" or "normal" when describing pathology findings.
Better: You might encourage the pathologist to use terms like, "stain negative for [whatever he was looking for]" or "study did not result in differential diagnosis."
Texas Subscriber
Pathology/Lab Coding Alert
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