Wiki KOH Slides? Oh boy.

[AprilSueMadison]

One of my providers has recently started doing KOH slide prep and I know nothing about this. At least...I think that is what he doing.

I'm hoping someone here can offer me some assistance for this pathology service.

1 - Provider has a note that shows "KOH findings are positive". That is his ONLY reference to the KOH slide though. What SHOULD the notes say to allow me to bill this correctly? Are there certain terms or words I'm looking for, or is "KOH findings..." enough to bill the code?

2 - For commercial insurance, I've found the code 87220. But, for Medicare patients I found an article showing I should bill 87220 + a HCPCS code of Q0112. Is that accurate?

3 - If a patient comes in with a rash for example, we do an exam and the the provider does the KOH slide, I CAN bill an E/M code for that correct? The pathology is not a separate procedure as I understand it.

4 - FINALLY, I've looked online through First Coast Service Options to find the allowables. There are none for 87220. If 87220 and Q0112 are the correct codes, how in the world do I set the pricing for charges on these?



Any information that you can offer, I would appreciate it. I want to be sure I'm billing these correctly

 

[jbhickman]

Koh

The chart should indicate what part of the body the scrapping came from.
EX: Left Lower Anterior Leg

87220 is correct for commercial carriers
Q0112 is for Medicare.

 

[AprilSueMadison]

So with Medicare then, do I ONLY bill Q0112? Or do I bill out both?

I've looked around and it seems the pricing for these is relatively low, around 10 dollars or so. I can't find anything suggesting otherwise, or quite frankly that these will pay, but I set the pricing at 10 dollars in our system. Any thoughts on this?

And any suggestions for the E/M charging with this path?