2007 CPT-4/HCPCS Updates - Pathology Billing Restrictions

The following CPT-4 codes must be billed with the appropriate split-bill modifiers (26, 99, TC or ZS): 82107, 83698, 83913, 86788, 86789, 87305, 87498, 87640, 87641, 87653 and 87808. Code 88314 is not reimbursable with codes 17311 Ð 17315 for a routine frozen section stain. However, it is separately reimbursable for a non-routine frozen section stain when it is billed with modifier 59. Codes 88302 Ð 88309 (surgical pathology) are not reimbursable with codes 17311 Ð 17315 (Mohs surgery) unless there is documentation that the pathology claims are for different specimens.

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INDUSTRY NEWS TAGS: California Medi-Cal

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