Billing/Coding question for Frozen sections
Started by musom
#1
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Agree with above. Any frozen done on an individual specimen is 88331. The only time you use 88332 is for a second frozen section (or more) on the same specimen/part.
And don't forget that if it is a gross assessment only intraoperative consult or they need to come show you something in OR, document it and bill 88329.
If you do touch prep with a frozen (as many sentinel nodes and brain tumors do) don't forget to bill and 88334 in addition to the 88331 (you can't bill and 88333 with an 88331).
If you do touch prep with a frozen (as many sentinel nodes and brain tumors do) don't forget to bill and 88334 in addition to the 88331 (you can't bill and 88333 with an 88331).
I know many newer surgeons don't freeze SLN, but we got some older ones that do. I always try not to freeze breast tissue.
A lot of our surgeons freeze SNs but then we do the three slide protocol on the remainder. I'll TP them if they look like they're going to be fatty.
*Hate* freezing breast margins. Got occasional retroareolar fat (also kind of a nightmare to freeze) but the actual margin was a rare thing, but always a rampaging pain when it happened.
We didn't really freeze melanoma SNs, thank god.
*Hate* freezing breast margins. Got occasional retroareolar fat (also kind of a nightmare to freeze) but the actual margin was a rare thing, but always a rampaging pain when it happened.
We didn't really freeze melanoma SNs, thank god.
I don't know about billing the 88334 anymore. My interpretation of the most recent Padget coding manual was to not code 88333 or 88334 with an 88331. I could very well be wrong about this.
We still bill 88331 + 88334 on rare cases, such as brain lesions when we do a squash prep, still don't know what to call it, then try a frozen. Medicare may or may not pay it, but BC/BS et al. still seem to.
We get frozens on sentinel nodes when there is a mastectomy with immediate reconstruction. They don't want to go back into the axilla after a reconstruction, and they don't want to delay the reconstruction if they don't have to. Unfortunately it seems like most of the breast cases we get are mastectomies with reconstruction. And a lot of these are offsite frozens where we have to send someone to a smaller hospital just for that purpose. Not very efficient. It has been a hard battle to reduce or eliminate these. And our institution is not one that I would say does excessive frozens.
We never freeze margins though.
We never freeze margins though.
