Wiki Prostate Biopsies

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kiplynj

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Hello

Can you give me some guidance here please? Re: the billing of code 88305 in association with prostate Bx -- It is understood that a sextant approach is used for this Bx. It is expected that no more than two core samples are to be extracted from each of the six geographic Bx locations. This would result in 6 vials containing up to a total of 12 core samples. What is the unit of billing for code 88305 x12 (indicating specimens)?

Thanks
Kiplyn Gilbert
 
http://www.auanet.org/advnews/hpbrief/view.cfm?i=2857&a=5646

•88305 – Surgical pathology, gross and microscopic examination (1-9 specimens)
•G0416 – Surgical pathology, gross and microscopic examination for prostate needle biopsies, any method (10-20 specimens)
•G0417 – Surgical pathology, gross and microscopic examination for prostate needle biopsies, any method (21-40 specimens)
•G0418 – Surgical pathology, gross and microscopic examination for prostate needle biopsies, any method (41-60 specimens)
•G0419 – Surgical pathology, gross and microscopic examination for prostate needle biopsies, any method (greater than 60 specimens).
 
CodingKing said:
http://www.auanet.org/advnews/hpbrief/view.cfm?i=2857&a=5646

•88305 – Surgical pathology, gross and microscopic examination (1-9 specimens)
•G0416 – Surgical pathology, gross and microscopic examination for prostate needle biopsies, any method (10-20 specimens)
•G0417 – Surgical pathology, gross and microscopic examination for prostate needle biopsies, any method (21-40 specimens)
•G0418 – Surgical pathology, gross and microscopic examination for prostate needle biopsies, any method (41-60 specimens)
•G0419 – Surgical pathology, gross and microscopic examination for prostate needle biopsies, any method (greater than 60 specimens).
Click to expand...

It's for a commercial payor who is not accepting the "G" codes. From understanding it should be 88305 x12.
 
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