Re: [Histonet] problem with 88305 reimbursement
Is it a skilled nursing facility? If a patient is in an SNF (for rehab or other reasons) then Medicare will not pay. The testing facility has to contract with the SNF for payment. I have not seen this with a hospital, though. Brendal Finlay, HT (ASCP) On Jan 29, 2013, at 12:51 PM, Cynthia Pyse cp...@x-celllab.com wrote: Hi Histonetters We are currently having a problem with our Medicare reimbursement on the tech component of the 88305. If the patient has been seen at a hospital, either in-patient or out- patient, we are told by Medicare that we have to contract with that hospital to bill for the 88305. The biopsy was not done at the hospital but in a doctor's office. According to Medicare if there the same date of service it can only be billed through the hospital. Medicare is calling it consolidated billing. I can't see how the hospital can bill for something that was done in the doctor's office then sent to an independent lab. Is anyone else having this problem? How are you handling it with Medicare? Any help would be appreciated. Thanks in advance Cindy Cindy Pyse, CLT, HT (ASCP) Laboratory Manager X-Cell Laboratories 20 Northpointe Parkway Suite 100 Amherst, NY 14228 716-250-9235 etx. 232 e-mail cp...@x-celllab.com ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] problem with 88305 reimbursement
It's not a SNF but an actual hospital. These are outpatient that go to the hospital for any service. Example, one patient went to a clinic for a vaccination, another went for blood work. None of which has anything to do with the biopsy from the doctor's office. Cindy Pyse, CLT, HT (ASCP) Laboratory Manager X-Cell Laboratories 20 Northpointe Parkway Suite 100 Amherst, NY 14228 716-250-9235 etx. 232 e-mail cp...@x-celllab.com -Original Message- From: Brendal Finlay [mailto:brendal.fin...@medicalcenterclinic.com] Sent: Tuesday, January 29, 2013 2:32 PM To: Cynthia Pyse Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] problem with 88305 reimbursement Is it a skilled nursing facility? If a patient is in an SNF (for rehab or other reasons) then Medicare will not pay. The testing facility has to contract with the SNF for payment. I have not seen this with a hospital, though. Brendal Finlay, HT (ASCP) On Jan 29, 2013, at 12:51 PM, Cynthia Pyse cp...@x-celllab.com wrote: Hi Histonetters We are currently having a problem with our Medicare reimbursement on the tech component of the 88305. If the patient has been seen at a hospital, either in-patient or out- patient, we are told by Medicare that we have to contract with that hospital to bill for the 88305. The biopsy was not done at the hospital but in a doctor's office. According to Medicare if there the same date of service it can only be billed through the hospital. Medicare is calling it consolidated billing. I can't see how the hospital can bill for something that was done in the doctor's office then sent to an independent lab. Is anyone else having this problem? How are you handling it with Medicare? Any help would be appreciated. Thanks in advance Cindy Cindy Pyse, CLT, HT (ASCP) Laboratory Manager X-Cell Laboratories 20 Northpointe Parkway Suite 100 Amherst, NY 14228 716-250-9235 etx. 232 e-mail cp...@x-celllab.com ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] problem with 88305 reimbursement
How is this if the biopsy procedure is being done at the physician's facility? I have heard though this is just the start of including the biopsy within the DRG if it comes back with positive for cancer,, but once again this is a hear say. This is also to include any testing for IHC, ISH, or molecular testing. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cynthia Pyse Sent: Tuesday, January 29, 2013 11:51 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] problem with 88305 reimbursement Hi Histonetters We are currently having a problem with our Medicare reimbursement on the tech component of the 88305. If the patient has been seen at a hospital, either in-patient or out- patient, we are told by Medicare that we have to contract with that hospital to bill for the 88305. The biopsy was not done at the hospital but in a doctor's office. According to Medicare if there the same date of service it can only be billed through the hospital. Medicare is calling it consolidated billing. I can't see how the hospital can bill for something that was done in the doctor's office then sent to an independent lab. Is anyone else having this problem? How are you handling it with Medicare? Any help would be appreciated. Thanks in advance Cindy Cindy Pyse, CLT, HT (ASCP) Laboratory Manager X-Cell Laboratories 20 Northpointe Parkway Suite 100 Amherst, NY 14228 716-250-9235 etx. 232 e-mail cp...@x-celllab.com ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet __ This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution, or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at either the e-mail, fax, address, or telephone number listed above and delete this e-mail from your computer. Thank You. __ ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
