GI bx CPT code - overbilling?

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10+ Year Member
Overbilling? Got it from a CPT coding presentation.

2 polyps in the same container can be billed as 88305x2 if gross description separates them as "small" and "large"?

pretty soon I'll start seeing extra small, small, medium, large :laugh:
 
This is excepted practice by CMS. Containers do not matter.
Does the labeling identify them as separate lesions? Is one really larger the other ?
 
AZpath said:
This is excepted practice by CMS. Containers do not matter.
Does the labeling identify them as separate lesions? Is one really larger the other ?
Click to expand...
Interesting.

Yes, the container says 2 polyps. Yes, there is a size difference.

Thanks
 
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On the down side you will find a doc will put in 16 separate polyps labelled " colon polyps @ 50 to 90 cm". That's a single 88305. No way you can justify that as more.

A separate container is always helpful but not required.

Another example: One large container labelled Hysterectomy & BSO with omentum (endometrial cancer case). You get to charge for the omentum and the hysterectomy.
Same concept.
 
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