Wiki Billing for Shave biopsy 11102 and 87207-26 -or- 88305-26 ?

[cinike]

I have the following situation:

1) My Doctor personally did a shave biopsy on a patient and billed 11102.

2) My Doctor collected the specimen and prepared it for delivery to the lab.

3) The lab sent back a report.

4) My Doctor read the report, evaluated it and discussed it with the patient.

Questions:
A) Can My Doctor bill 87207-26 for reading, evaluating and discussing the report
with the patient in addition to an E/M code (99212)?

B) Should my Doctor bill 88305-26 instead of 87207-26?

C) If 88305-26 is the better code, can 88305-26 be billed and an E/M code (99212)
for the same date of service?

Thanks!

 

[iowagirl77]

Collection of the specimen would be included in 11102, as stated in the biopsy guidelines of the CPT manual. I don't believe your provider can bill the pathology codes unless he has met the following:

A separate, signed interpretation and report similar to that which would be prepared by a specialist in the field is required to support the billing of the professional component of such diagnostic tests. (CMS. Medicare Claims Processing Manual (Pub. 100-4). Chapter 13 – Radiology Services and Other Diagnostic Procedures, §100.1.)