Coding, Classification and Reimbursement

  • 1.  Mohs with frozen section

    Posted 01-08-2019 12:34
    I have a dermatologist that performs Mohs procedures and desires to bill separately for a frozen section.  Unbundling is not a issue in this case because there is documentation to support that the biopsy/frozen section is for a lesion on a separate body site from the site being treated by Mohs and it has not been previously biopsied.

    My concern is that the code they wish to bill is for a path consult.  The doctor is both harvesting the specimen and performing the pathology service.  No consult is involved in this.

    88331, Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen

    Lay description:
    These procedures may also be referred to as an intraoperative pathology exam with frozen section (FS). A pathology consultation involves an opinion or advice on the presence or absence of diseased or abnormal tissue provided at the request of another physician. These codes describe such a pathology consultation during the course of a surgery. The codes include a gross examination of tissue and frozen sections, including a written interpretation of findings.

    Has anyone experienced this in the past or know if this code can be billed when no actual consult took place?

    Thanks for your help with this.

    Jenny Harvey, RHIT, CPHQ, CPMA, CPC