If you are coding for “sinus stripping”, watch your steps because you may lose out on nearly $43 in payment. With only CPT-listed nasal-tissue specimens, you’re bound to encounter other terminology in your pathology reports. The following five steps will ensure you select the right code and avoid under-or over-charging for your pathologist’s service.
You need to differentiate biopsy from polyps
The task is easy when the pathologist uses language that specifically aligns with CPT’s nasal tissue specimen codes. When the pathology report identifies the tissue as nasal polyps or nasal biopsy, you should go for 88304 or 88305.
Lump turbinate, septum under bone fragment code
When the pathologist examines an unlisted specimen, you need to assign the code that most closely reflects the physician work involved when compared to other specimens assigned to that code. That can lead to gray areas but the following code assignments are not uncommon among pathologists:
Mixed Bony/Mucosal Tissue Takes Biopsy Code
You might run into several unlisted sinus terms in a pathology report that you can code using the following guidance:
• Sinus contents
• Ethmoid tissue
• Sinus strippings
Do away with nasal Polyp ‘S’ myth
You should not let a common myth force nasal specimens into an artificial charge bundling rule. Although 88304’s descriptor “inflammatory nasal polyps is plural, you can bill multiple units for separately identified polyp specimens.
Learn distinct specimen ABC’s
Do not miss opportunities to charge separately when documentation supports.
• Separate specimens: If the pathology report documents separately identified and diagnosed specimens, you should code each separately.
• Multiple units: You can also code separately for multiple units.
For more tips on pathology coding, attending pathology conferences is a good way to go about.