Benefits to Change for Clinical Pathology Consultations

Effective for dates of service on or after August 1, 2012, benefits for clinical pathology consultations have changed for Texas Medicaid. Clinical pathology consultations (procedure code 80500 or 80502) are a benefit of Texas Medicaid for services rendered by a consultant who is either a clinical pathologist or a geneticist. Routine conversations between a consultant and an attending physician about test orders or results are not considered consultations. Clinical pathology consultations (procedure code 80500 or 80502) are no longer limited to one service per day. A clinical pathology consultation will be considered for reimbursement when specific documentation is submitted with the claim. A clinical pathology consultation claim that does not include all of the required information will be denied.