Lorisvg
Networker
I am hoping for some feed back on a problem we are having. We are a family practice office, that uses an outside lab for our pathology needs. When a patient comes in for her routine pap smear, our reference lab charges us for 88175. Which is correct.
88175 is for a thin prep with reading through an automated system and manual rescreening or review, under physician supervision.
The problem is that they have now recently started also charging us 88141 with a modifier 26 whenever the machine kicks a pap out for whatever reason, including insufficient cells.
88141 is for cytopathology, cervical or vaginal (any reporting system) requiring interpretation by a physician.
Our problem is that we don't feel we can legally bill the patient for a professional component that we did not perform. There is also the fact that it seems like double billing for the same service, because 88175 includes the review.
We have tried to resolve this with them, but they have not been very responsive. Any thoughts on if this is correct billing, or resources that back up our stance. Thanks!
88175 is for a thin prep with reading through an automated system and manual rescreening or review, under physician supervision.
The problem is that they have now recently started also charging us 88141 with a modifier 26 whenever the machine kicks a pap out for whatever reason, including insufficient cells.
88141 is for cytopathology, cervical or vaginal (any reporting system) requiring interpretation by a physician.
Our problem is that we don't feel we can legally bill the patient for a professional component that we did not perform. There is also the fact that it seems like double billing for the same service, because 88175 includes the review.
We have tried to resolve this with them, but they have not been very responsive. Any thoughts on if this is correct billing, or resources that back up our stance. Thanks!