Re: Charge Code 88180 Question

From: Sharon F. Vogt (svogt@earthlink.net)
Date: Sat Jan 16 1999 - 20:18:53 EST


>>is it justifiable to charge for the marker a second time.
>> Example:  in this 4 tube panel of CD3/CD19, CD5/CD19, CD10/CD19, and
>> CD5/CD23 would this be correctly billed as CPT-88180 (X5) or would it be
>> understandable and justifiable to bill CPT-88180 (X8).

>The rule of thumb we use here is,1) can you clinically justify it as 
>medically necessary (there is ample published literature to support 
>the usefulness of the combinations you mentioned)2) did you perform 
>the test 3) did you report the results.

Joanne,

Thanks for the info. My advice to the issuer of the original question was 
to look into 3-color testing, since that would obviate the need for at 
least some of the repeated markers. Should the two-color labs be 
"allowed" to charge for additional combinations because they aren't 
motivated to perform three-color?  

Two-color flow, with the described billing method, fails to serve the 
patient very well. Three-color testing, while attainable, is no cure-all 
as not everyone chooses the same combinations, some labs have 4-color 
capability, etc. We should consider this more evidence for pursuit of 
some kind of consensus regarding antibody selection and billing.

sharon


Sharon F. Vogt, MT (ASCP)
Pathology/Special Oncology
Dekalb Medical Center
2701 N. Decatur Road
Atlanta, GA 30033

PH:  404-501-5253
FAX: 404-297-0444
svogt@earthlink.net



This archive was generated by hypermail 2b29 : Wed Apr 03 2002 - 11:52:57 EST