Wiki Pathologist to Pathologist Consultations

[eeast]

I work in a hospital laboratory and have just found out that our in-house pathologists are billing for the consultations (technical for the hospital, professional for themselves) when they are unable to make a definitive diagnosis and send the slides out to a reference laboratory.

This doesn't seem right to me. If anything, the reference lab should be billing these (both technical and professional) to the inpatients. When our pathologist gets the report back, he then provides an addendum report.

Any references or opinions on this issue for me?

Ellen

 

[bbooks]

If your pathologist is doing the technical and rendering a diagnosis, then, yes, they can charge for the TC and the 26 for the appropriate CPT (88302-88309). If they felt the tissue required an additional consultation, then the reference lab can charge for a consultation (88321-88325) and for any additional stains they might do.

This is what happens in our office. There are a small number of cases that are particularly complex for which our pathologist would like a specialist's consultation. In very rare instances, the entire case is sent to the specialist before any technical or professional work is done on the case, and in these instances we will not submit a charge. But more commonly (on a very small number of cases) we will have done the technical work and our pathologist will have rendered a diagnosis, but he/she will feel like they would like a specialist to consult on the case. The materials will be sent to the reference lab, the specialist pathologist will render a consultation report, and our pathologist will create an addendum to the report incorporating that information.