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Answer: Assuming the pathologist receives a request to review the material from another facility and writes a report on the findings, this service would be considered a consultation on referred material. This service has three codes: 88321 (consultation and report on referred slides prepared elsewhere), 88323 (consultation and report on referred material requiring preparation of slides) and 88325 (consultation, comprehensive, with review of records and specimens, with report on referred material).
Because the slides, not the specimens, were received from another institute, it would be incorrect to report 88323, which is used to report the service when it requires preparation of slides for routine histologic staining.
However, whether to report 88325 or multiple units of 88321 depends on the extent of the consultation. According to CPT Assistant April 1997, "Code 88321 is used to report a consultation on a referred slide(s) from a specimen." So if the pathologist reviewed and reported on the referred slides from three specimens, it may be correct, in some circumstances, to report 88321 x 3. For example, it may be appropriate if the referring physician specifically requests a consultation on three of the four specimens, or if the specimens relate to different conditions for the same patient. In these cases, the specimens might be from different body sites or different dates of collection, or may relate to different diagnoses for the same patient.
Or it may be appropriate to report 88325 for the service you described, depending on the breadth of the consultation. Code 88325 is reserved for cases involving a comprehensive review of the patient record. If the pathologist is asked to review the patient history, surgical notes, results of oncologist's consultations and pathology reports, 88325 would be appropriate. It is not suitable to code 88325 when only the pathology reports are reviewed. |
