Tom- I know that the discussions with CMS in instituting the changes indicated your "thoughts" to be true. However, as disappointing as it may be, the enforcement of these new regulations will be done by many different insurance carriers and people so there is no guarantee of the policy for your specific carrier. Despite these anticipated changes, there is no certainty that the present fact that policies on flow cytometry reimbursement vary between geographic regions (caps, no caps, number of caps, etc.) will change. If you want absolute certainty, you should request a decision in writing from your local medicare or CMS carrier of what their interpretation of the proposed guidelines are. However, like any bureaucracy even this does not guarantee it will not change in the next month or that they even have considered the matter. Bruce Bruce H. Davis, M.D. Trillium Diagnostics, LLC c/o Maine Medical Center Research Institute 81 Research Drive Scarborough, Maine 04074 USA www.trilliumdx.com PHONE: 207-885-8113 FAX: 207-885-8110 Email: davisb@mmc.org >>> "Tom Sawyer" <TSAWYER@mco.edu> 12/10/04 17:16 PM >>> Sara's questions are very important. There seems to be a great deal of confusion out there on these issues. We are debating the same issues at our institution and would like to reach a decision by Jan 1. There must/should be a correct way of doing this not a way someone "thinks" is the correct way. I "think" the codes for T's, B's and NK's should be used for what most people call immunodeficiency panels and "think" the new codes 88184 and 88185 should be use for immunophenotyping of leukemias and lymphomas. I was also under the impression that the CD45 gating control was not billable when performing things such as CD4 counts. Would someone who truely knows, not thinks they know, PLEASE respond to our questions. None of us want to recommend something that could lead to our institutions getting in trouble if they were audited by Medicare. Thank You, Tom Tom Sawyer Flow Cytometry Specialist Flow Cytometry Laboratory 32HE Medical College of Ohio 3055 Arlington Ave. Toledo, OH 43614-5806 Phone: 419.383.4212 Fax: 419.383.3076 email: tsawyer@mco.edu >>> "Markestad, Sara" <SMarkestad@sjha.org> 12/09/04 10:05AM >>> Hello Flowers! My question concerning the additional markers. 1: For our CD4/CD8 Panel we do the following markers: CD3,CD19,CD4,CD8,CD45 Our question is can we bill the following codes for this panel 86064 - for B cell total (CD19) 86359 - for T cell total (CD3) 86360 - for CD8 absolutes and ratio 86361 - for CD4 absolute count 88185 - CD45 2. For our Leukemia and Lymphoma Panel Can we bill this way: 86064 - for B cell total (CD19) 86359 - for T cell Total (CD3) 86379 - for NK cells (CD56) 88184 - for our first marker 88185 - for all other markers that are done in the panel or do we have to just use 88184 and 88185 for all makers in a Leukemia/Lymphoma Panel. 3. The CD34 stem cell CPT is that for those labs that do Bone Marrow Transplant. We use it in our L/L Panel but we didn't think that we could bill this antibody 86587 because we don't do transplants here just evaluations. Any help with these questions would be greatly appreciated. Sara Markestad, MT (ASCP) St. Joseph's Hospital of Atlanta 404-851-7744 Confidentiality Notice ** The information contained in this message may be privileged and is confidential information intended for the use of the addressee listed above. If you are neither the intended recipient nor the employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this communication in error, please notify us immediately by replying to the message and deleting it from your computer. Thank you. Saint Josephs Health System, Inc.Received on Mon Dec 13 15:58:00 2004
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