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CodeMap® Compliance Briefing: 12/19/2008


 

Editor's Welcome:

 

In its final rule implementing the 2009 Medicare Physician Fee Schedule, CMS published new HCPCS codes for reporting prostate saturation biopsies. Pathologists formerly reported these biopsies using CPT code 88305 once for each core sample obtained. Patients generally have 30 to 60 specimens taken for this type of biopsy. 

CMS believes that billing 88305 individually for the evaluation of each biopsy sample results in overpayment and have thus taken the measures described below to correct this perceived problem. Please email us with any questions, comments, or suggestions regarding this or other reimbursement and coding issues. This is the last CodeMap Comp....

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