Medical Billing Code Restrictions Could Become Routine

Medical Billing Code Restrictions Could Become Routine

Medical billing coding restrictions may become a trend in future years. Recently, laboratories have been the victim to this trend. The Centers for Medicare and Medicaid services has proposed a limit on the medical billing codes 88305 and 88342.

The medical billing codes 88305 and 88342 are laboratory processing and pathology interpretation codes. The Centers for Medicare and Medicaid services are proposing that only two 88305 codes and 4 88342 codes may be billed for each patient per date of service. This medical billing change would go into effect on July 01, 2006.

There are four agencies involved in this proposal . The Centers for Medicare and Medicaid services (CMS) created the proposal with the Medicaid services National Correct Coding Initiative (NCCI). These two groups sent the information to the American Medical Association (AMA) , who then sent the proposal to the College of American Pathologists (CAP). It is almost guaranteed that that College of American Pathology will not agree with this medical billing change.

Though it is possible that the National Correct Coding Initiative will follow the suggestions from the College of American Pathology, they tend to follow their own medical billing rules. Even if suggestions are followed, it could take several months for them to take action.

Even if this medical billing change does not come to fruition, it is a sign of things to come. Medical billing coding restrictions will most likely be present in the future. Laboratories may be the current target, but no one is safe. Make sure your practice is ready for any medical billing coding restrictions that may come about in the next few years. If you do not agree with these changes, voice your medical billing opinions to the Centers for Medicare and Medicaid services office.

View all Articles by: Melissa Clark, CCS-P