Wiki Need PQRS help!

[debneas]

At what point do you register a patient for the PQRS for a new melanoma? Example: A doctor does a bx and it comes back positive for malignant melanoma. Since every provider needs to have one new diagnosed malignant melanoma for the year do you now send a corrected claim for that date of the bx and change the diagnosis code or at the patient's next visit you register that visit?

 

[CatchTheWind]

You can use the melanoma diagnosis on the return visit.

 

[lillydog845]

Hold the charges for the bx visit, then bill w/ 172.X code if path is positive for melanoma.

 

[CatchTheWind]

That works if you hold biopsy claims pending results, but if your practice sends out biopsy claims right away (with diagnosis 238.2 (neoplasm of undecided behavior)), then by the time you get the melanoma result, the claim has already done out with 238.2.

 

[mitchellde]

That works if you hold biopsy claims pending results, but if your practice sends out biopsy claims right away (with diagnosis 238.2 (neoplasm of undecided behavior)), then by the time you get the melanoma result, the claim has already done out with 238.2.

The biopsy can be billed either with or without the path if the claim is held for path the use the path result. If the claim is not held you cannot use a path dx code. 238.2 is a path dx code and you cannot use it without the path report. The only code you can assign when you have no path report is the code for skin disorder.
From the code book:
Categories 235-238classify by site certain histomorphologically well-defined neoplasm...
That mean the cellular activity observed under a microscope cannot be defined as benign or malignant.
This is the ICD-9 classification definition for these codes. You cannot apply any other definition.

 

[jamiejohnson63@earthlink.net]

Pqrs for melanoma

Do you send a pqrs for existing melanoma's?
And if so what codes for the 9 measures.
Thanks for your help