Coding Corner

Q. If we review IHC-stained slides submitted with a consultation case can we bill the professional component for the interpretation?  What date of service would we use for the consultation?

A. For the first part of the question the answer is no, you cannot report for the interpretation of IHC slides previously prepared and reviewed elsewhere as they are included in the consultation code.

Per Medicare, the correct date of service to use for the consultation would be the collected date, unless the specimen is an archived specimen (in storage more than 30 days) in which case you would use the date taken from storage.  For a stored specimen (in storage more than 14 days but not more than 30), use the date you performed the service.

Q. When reporting the ICD-9 codes, does the order they are listed in matter?

A. If the physician has confirmed a diagnosis based on the results of a diagnostic test the primary, or first-listed, ICD-9 code should reflect that diagnosis. The condition or symptoms that prompted the ordering of the test may be reported as additional diagnoses if they are not fully explained or related to the confirmed diagnosis. 

If the diagnostic test did not provide a diagnosis or was normal, the interpreting physician should code the condition warranting the test as the primary diagnosis, followed by the code(s) for any other contributing condition or symptom as applicable to the case.