tci Medicare Compliance & Reimbursement - 2013 Issue 21

Reader Question: Surgeon Needn't Wait for Path Report--But It Helps

Question: Is there a hard-and-fast billing rule that requires us to wait for the pathology report to send out our surgeon’s claims? Answer: While there is no hard-and-fast rule that requires you to wait for the pathology report before billing the surgeon’s work, doing so is to your advantage. Read on to see three good reasons why you should wait for the path report: 1. Because ICD-9 outpatient coding guidelines state that you should not code a “rule-out” diagnosis, you’ll be left coding signs and symptoms if you don’t wait for the path report...

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