Wiki Coding from path report

[kortega65]

Needing thoughts about coding from path report vs coding from tx notes. got a case where medicare won't pay for SK removal but will pay for beign nevus uncertain behavior the path report says beign neoplasm 216.6 but my co-worker thinks we should be coding it as 702.19. I told her to code to what the path report says, but she thinks the pathology lab is coding it to what will get paid, the patient also called another dermatology office for verification and they told her they would change the code to what will get paid.

 

[Tonyj]

Needing thoughts about coding from path report vs coding from tx notes. got a case where medicare won't pay for SK removal but will pay for beign nevus uncertain behavior the path report says beign neoplasm 216.6 but my co-worker thinks we should be coding it as 702.19. I told her to code to what the path report says, but she thinks the pathology lab is coding it to what will get paid, the patient also called another dermatology office for verification and they told her they would change the code to what will get paid.

I thought we were taught to code what the physician dictates not what will get paid. An ABN form is provided for scenarios where the code may not be payable.